Organization
STAND-UP MRI OF LAKELAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J. GOODEMOTE RN, PHD (CEO)
(863) 577-0303
Entity
Organization
Contact information
Practice address
1121 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4655
(863) 688-2334
(863) 577-0301
Mailing address
2120 LAKELAND HILLS BLVD, LAKELAND, FL 33805-2906
(863) 688-2334
(863) 577-0301
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
FL
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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