LAKESIDE OPEN MRI OF TAVARES – NPI #1467491993
Clinic/Center

LAKESIDE OPEN MRI OF TAVARES is an AHC clinic located in TAVARES, FL. NPPES has assigned the NPI number 1467491993 to LAKESIDE OPEN MRI OF TAVARES on June 06, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LAKESIDE OPEN MRI OF TAVARES” is a dba name, the actual legal business name for this organization is OPEN MRI OF ORLANDO INC. The primary taxonomy selected by this provider is 261QR0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Radiology

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKESIDE OPEN MRI OF TAVARES below.

NPI Profile for
OPEN MRI OF ORLANDO INC

NPI Number
1467491993
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
OPEN MRI OF ORLANDO INC
Doing Business As (dba): LAKESIDE OPEN MRI OF TAVARES
Primary location
1879 NIGHTINGALE LN
SUITE A-1
TAVARES, FL 32778-4363
Phone: (352) 742-9211 Fax: (352) 742-9406
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SHAUN WOODBURN
PRESIDENT
Phone: (352) 742-9211
Updated
Identifiers

Identifiers for LAKESIDE OPEN MRI OF TAVARES

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBLUE CROSS AND BLUE SHEILFLV2544
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR0200X
- Clinic/Center / Radiology (Primary)		 FL HCC5152

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.