Organization Name: | HEATHROW IMAGING LLC |
NPI Number: | 1043416928 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAVELLE R HARDIN (CREDENTIALING COORDINATOR) |
Mailing Address: | 1343 South International Parkway Suite 1351 Bldg 3 Lake Mary |
State: | FL US |
Postal Code: | 327461401 |
Phone Number: | 4073334464 |
Fax Number: | 4073334393 |
NPI Enumeration Date: | 06/26/2007 |
NPI Last Update Date: | 10/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |