Organization
LAKE MEDICAL IMAGING AND BREAST CENTER AT THE VILLAGES LLC
Active
Other names
Lake Medical Imaging at Mulberry Grove
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA LEE FLOYD PHD (DIRECTOR, RISK MANAGEMENT)
(365) 352-2583
Entity
Organization
Contact information
Practice address
8801 SE 165TH MULBERRY LN, THE VILLAGES, FL 32162-5887
(352) 787-5858
(352) 787-4655
Mailing address
734 N 3RD ST STE 115, LEESBURG, FL 34748-5287
(352) 787-5858
(352) 728-6749
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101183203
—
FL
Enumeration date
06/22/2021
Last updated
06/23/2021
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