FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC (NPI# 1942389747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942389747 |
| Entity Type | Organization |
| Organization Name | FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC |
| Other Organization Name | ADVENTHEALTH IMAGING PRINCETON |
| Practice Address |
235 E Princeton St Suite 100 Orlando FL 32804-5553 |
| Mailing Address |
900 Winderley Pl Ste 2100 Maitland FL 32751-4191 |
| Practice Telephone | 4077670433 |
| Mailing Telephone | 4077670433 |
| Mailing Fax Number | 4073030893 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2019-06-14 |
| Authorized Official Name | DR. GERY FELSBERG (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4077670433 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 265644202 | 05 | |
| FL | BCBS GRP-LOCATION | V2901 | 01 |
| Other Name | Type Code |
|---|---|
| AdventHealth Imaging Princeton | Doing Business As Name - Organization |
| Florida Radiology Imaging at Princeton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285243394 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 2488 E Irlo Bronson Memorial Hwy, Kissimmee, FL 34744-4948 | 2020-07-24 |
| 1912463258 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 2200 Fowler Grove Blvd Ste 60, Winter Garden, FL 34787-5597 | 2019-02-12 |
| 1851414023 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 12301 Lake Underhill Road, Suite 103, Orlando, FL 32828 | 2007-04-10 |
| 1003983610 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 6000 Turkey Lake Rd, Suite 107, Orlando, FL 32819-4200 | 2006-11-29 |
| 1891874699 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 8000 Red Bug Lake Rd, Suite 120, Oviedo, FL 32765-9226 | 2006-11-03 |
| Street Address |
235 E PRINCETON ST SUITE 100 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32804-5553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043285422 | Diane E Graumlich | Nurse Practitioner | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2006-02-21 |
| 1124592779 | Lauren Michelle Gover | Obstetrics & Gynecology | 235 E Princeton St, Orlando, FL 32804-5553 | 2019-01-16 |
| 1467891820 | Stacy Michelle Butschek | Advanced Practice Midwife | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2013-06-19 |
| 1508121948 | Jill Marie Johnson | Obstetrics & Gynecology | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2012-07-11 |
| 1558434225 | Melanie Reis | Nurse Practitioner | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2006-11-17 |
| 1336164326 | D. Ashley Hill | Obstetrics & Gynecology | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2006-07-12 |
| 1861417859 | Kristin M. Jackson | Obstetrics & Gynecology | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2006-07-12 |
| 1538191663 | Scott Allen Boone | Obstetrics & Gynecology | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2006-07-07 |
| 1104853464 | Lynda Jean Balint | Obstetrics & Gynecology | 235 E Princeton St, Suite 200, Orlando, FL 32804-5553 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881252716 | Alyssa Bass | Counselor | 3130 Edgewater Dr, Orlando, FL 32804 | 2019-06-05 |
| 1841856366 | Debora Cheryl Ramirez | Technician/Technologist | 1231 North Orange Ave, Orlando, FL 32804 | 2019-05-10 |
| 1679074009 | Jessica Dobbs | Counselor | 3801 Grant Blvd, Orlando, FL 32804 | 2018-02-21 |
| 1881109031 | Pedro Mendez Jr. | Counselor | 1800 W. Colonial Drive, Orlando, FL 32804 | 2017-12-11 |
| 1902259310 | Michael Lo | Nurse Practitioner | 2400 N Orange Ave Ste 302, Orlando, FL 32804 | 2016-07-20 |
| 1083093595 | Michael Gregg | Student in an Organized Health Care Education/Training Program | 2415 North Orange Avenue, Suite 400, Orlando, FL 32804 | 2015-05-29 |
| 1922485473 | Lindsay Rae Piet | Physician Assistant | 1910 N. Orange Ave., Orlando, FL 32804 | 2015-05-05 |
| 1093106189 | College Park Community Acupuncture & Herbal Medicine | Acupuncturist | 710 W. Princeton Street., Suite A, Orlando, FL 32804 | 2015-02-10 |
| 1164822359 | Orlando Sleep Solutions, LLC | Durable Medical Equipment & Medical Supplies | 2921 N. Orange Ave, Orlando, FL 32804 | 2014-08-26 |
| 1780926741 | Joseph Arturo Reza | Student in an Organized Health Care Education/Training Program | 2415 N Orange Ave #400, Orlando, FL 32804 | 2013-03-17 |
| Find all providers in zip 32804 | ||||
| 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 |
|---|---|---|---|---|
| 1790301661 | Clearview Diagnostic | Radiology | 8076 S Orange Blossom Trl, Orlando, FL 32809-7670 | 2020-06-17 |
| 1598201998 | Prime Radiology of Pine Hills, Inc | Radiology | 828 Mercy Drive, Suite 4, Orlando, FL 32808 | 2017-01-10 |
| 1366829707 | Florida United Radiology, Lc | Radiology | 8732 Fernwicke Ct, Orlando, FL 32819-3830 | 2015-05-06 |
| 1326440926 | Pedro Miguel Soler Sr. | Radiology | 3310 Northglen Dr, Orlando, FL 32806-6339 | 2014-09-25 |
| 1881000149 | Shalin Mahesh Soni | Radiology | 601 E Rollins St Ste 400, Orlando, FL 32803-1248 | 2014-07-08 |
| 1770843179 | Charles William George | Radiology | 3519 Cullen Lakeshore Drive, Orlando, FL 32812 | 2012-05-21 |
| 1972860831 | Hsiang-jer Tseng | Radiology | 601 E Rollins St Ste 470a, Orlando, FL 32803 | 2012-04-17 |
| 1134390743 | Amir Paydar | Radiology | 2650 Dade Ave, Apt 1422, Orlando, FL 32804-4607 | 2008-03-23 |
| 1649452517 | Unitedrads, LLC | Radiology | 11253 S Apopka Vineland Rd, Orlando, FL 32836 | 2007-12-03 |
| 1225189897 | Robert Marshall | Radiology | 51 W Kaley St, Orlando, FL 32806-2942 | 2007-01-12 |
| Find all providers in ORLANDO | ||||
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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.