Provider Demographics
NPI:1437302932
Name:HEALTHY 4 LIFE IMAGING, LLC
Entity Type:Organization
Organization Name:HEALTHY 4 LIFE IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:ADAMS-WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, ARRT
Authorized Official - Phone:407-880-3313
Mailing Address - Street 1:6856 S ROUND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-9645
Mailing Address - Country:US
Mailing Address - Phone:407-880-3313
Mailing Address - Fax:407-880-3313
Practice Address - Street 1:6856 S ROUND LAKE RD
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-9645
Practice Address - Country:US
Practice Address - Phone:407-880-3313
Practice Address - Fax:407-880-3313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory