Organization Name: | ADVANCED IMAGING CENTER OF LEESBURG LLC |
NPI Number: | 1033200332 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LESLIE J OLANDER (DIRECTOR) |
Mailing Address: | 13940 Highway 441 Suite 201 The Villages |
State: | FL US |
Postal Code: | 321598908 |
Phone Number: | 3527501551 |
Fax Number: | 3522051551 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 06/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |