Organization
RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND PA
Active
Other names
LAKELAND VASCULAR INSTITUTE OUTPATIENT CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J GOODEMOTE (CEO)
(863) 577-0303
Entity
Organization
Contact information
Practice address
3221 S FLORIDA AVE STE B, LAKELAND, FL 33803-4550
(863) 577-0296
Mailing address
2125 CRYSTAL GROVE DR, LAKELAND, FL 33801-6875
(863) 577-0303
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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