Provider Demographics
NPI:1710746771
Name:ENVISION IMAGING LLC
Entity Type:Organization
Organization Name:ENVISION IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIAGNOSTIC MEDICAL SONOGRAPHER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:V
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:862-247-5508
Mailing Address - Street 1:1029 SOUTHERN OAK LN
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2949
Mailing Address - Country:US
Mailing Address - Phone:862-247-5508
Mailing Address - Fax:
Practice Address - Street 1:2768 W LAKE MARY BLVD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3524
Practice Address - Country:US
Practice Address - Phone:862-247-5508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile