Provider Demographics
NPI:1134859846
Name:RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND
Entity type:Organization
Organization Name:RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-688-2334
Mailing Address - Street 1:PO BOX 20027
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-0027
Mailing Address - Country:US
Mailing Address - Phone:866-804-7649
Mailing Address - Fax:
Practice Address - Street 1:16504 US 301 S
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-2041
Practice Address - Country:US
Practice Address - Phone:813-642-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty