RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA (NPI# 1851803407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851803407 |
| Entity Type | Organization |
| Organization Name | RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA |
| Other Organization Name | RIS & LRH IMAGING, LLC LAKE MIRIAM |
| Practice Address |
4710 S Florida Ave Lakeland FL 33813-2165 |
| Mailing Address |
2125 Crystal Grove Dr Lakeland FL 33801-6875 |
| Practice Telephone | 8636882334 |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |
| Authorized Official Name | MARTHA LIMA (TREASURER) |
| Authorized Official Telephone | 8636882334 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| RIS & LRH IMAGING, LLC LAKE MIRIAM | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124530761 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 313 W Bass St, Kissimmee, FL 34741-5011 | 2017-11-03 |
| 1669744801 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 206 W Alexander St, Ste 1, Plant City, FL 33563-7100 | 2012-02-03 |
| 1295342087 | Radiology & Imaging Specialists of Lakeland, Pa | Pain Medicine | 205 N Plant Ave, Plant City, FL 33563-4731 | 2020-09-25 |
| 1063032993 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 1417 Lakeland Hills Blvd Ste 104, Lakeland, FL 33805-3200 | 2020-04-21 |
| 1073151064 | Radiology & Imaging Specialists of Lakeland, Pa | Surgery | 320 1st St N, Winter Haven, FL 33881-4113 | 2019-12-20 |
| 1326404195 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 130 Pablo St, Lakeland, FL 33803-3818 | 2016-01-11 |
| 1750654000 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 2120 Lakeland Hills Blvd, Lakeland, FL 33805-2906 | 2012-02-17 |
| 1649543992 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 1305 Lakeland Hills Blvd, Lakeland, FL 33805-4542 | 2012-02-17 |
| 1558634816 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 2120 Lakeland Hills Blvd, Lakeland, FL 33805-2906 | 2012-02-17 |
| 1235401480 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 3021 Lakeland Highlands Rd, Ste 3, Lakeland, FL 33803-4339 | 2012-02-03 |
| Street Address |
4710 S FLORIDA AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-2165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890462 | Ruben D Adriano | Internal Medicine | 4710 S Florida Ave, Lakeland, FL 33813-2165 | 2005-06-10 |
| 1386146215 | Shivani Patel | Nurse Practitioner | 4710 S Florida Ave, Lakeland, FL 33813 | 2018-03-07 |
| 1659870350 | Steven Ray Betteridge II | Nurse Practitioner | 4710 S Florida Ave, Lakeland, FL 33813 | 2018-02-08 |
| 1407355217 | Shirley Gwen Rogerson | Registered Nurse | 4710 S Florida Ave, Lakeland, FL 33813-2165 | 2018-02-07 |
| 1407203821 | Kessarin Gustafson | Nurse Practitioner | 4710 S Florida Ave, Lakeland, FL 33813-2165 | 2016-05-16 |
| 1134580053 | Paul Stephen Kent Jr. | Nurse Practitioner | 4710 S Florida Ave, Lakeland, FL 33813-2165 | 2016-03-20 |
| 1417312471 | Jackie Barnes | Nurse Practitioner | 4710 S Florida Ave, Lakeland, FL 33813-2165 | 2015-12-17 |
| 1740651272 | Nwamaka Ilonzo | Nurse Practitioner | 4710 S Florida Ave, Lakeland, FL 33813-2165 | 2015-10-09 |
| 1417353665 | Kelly Bolin | Nurse Practitioner | 4710 S Florida Ave, Lakeland, FL 33813 | 2014-11-17 |
| 1063858538 | Lakeland Regional Health Systems, Inc. | Clinic/Center | 4710 S Florida Ave, Lakeland, FL 33813-2165 | 2013-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013280361 | Radiology & Imaging Specialists of Lakeland Pa | Radiology | 1121 Lakeland Hills Blvd, Lakeland, FL 33805-4655 | 2012-02-17 |
| 1427049931 | Radiology & Imaging Specialists of Lakeland | Radiology | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2005-11-03 |
| 1063032993 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 1417 Lakeland Hills Blvd Ste 104, Lakeland, FL 33805-3200 | 2020-04-21 |
| 1487180659 | Central Florida Imaging of Lakeland LLC | Radiology | 1205 East Magnolia St, Suite 109, Lakeland, FL 33801 | 2017-05-10 |
| 1326404195 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 130 Pablo St, Lakeland, FL 33803-3818 | 2016-01-11 |
| 1427493931 | Tadeusz Ciszak | Radiology | 1305 Lakeland Hills Blvd, Lakeland, FL 33805-4542 | 2013-05-10 |
| 1750654000 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 2120 Lakeland Hills Blvd, Lakeland, FL 33805-2906 | 2012-02-17 |
| 1649543992 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 1305 Lakeland Hills Blvd, Lakeland, FL 33805-4542 | 2012-02-17 |
| 1558634816 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 2120 Lakeland Hills Blvd, Lakeland, FL 33805-2906 | 2012-02-17 |
| 1235401480 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 3021 Lakeland Highlands Rd, Ste 3, Lakeland, FL 33803-4339 | 2012-02-03 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.