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ADVENTHEALTH IMAGING LAKE NONA
NPI 1003208620
Radiology - Diagnostic Radiology in Orlando, FL

Active since February 19, 2015CLIA 10D2094029 · Waiver
9975 TAVISTOCK LAKES BLVD, SUITE 120, ORLANDO, FL 32827(407) 200-2865 Get Directions Write a Review

NPPES record last updated: February 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Adventhealth Imaging Lake Nona NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVENTHEALTH IMAGING LAKE NONA (NPI 1003208620) is a healthcare organization registered as a diagnostic radiology in Orlando, Florida and active in the NPI registry since February 2015. The organization holds a CLIA Waiver certificate valid through April 7, 2027 and lists Warren Wylie, Vp Radiology Enterprise, as its authorized official.

NPPES Registry Identity

NPI1003208620
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameFLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC
Location Address9975 TAVISTOCK LAKES BLVD, SUITE 120Orlando, FL 32827-7559
Mailing Address9975 Tavistock Lakes Blvd, Suite 120Orlando, FL 32827-7559
Phone(407) 200-2865
Organization SubpartNo
Authorized OfficialWarren WylieVp Radiology Enterprise · (407) 303-3358
Enumeration DateFebruary 19, 2015
Last NPPES UpdateFebruary 11, 2019
✔ NPI 1003208620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
9975 TAVISTOCK LAKES BLVD, Orlando, FL 32827
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Other Names 1

Doing Business AsAdventhealth Imaging Lake Nona

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2094029

Adventhealth Imaging Lake Nona · Orlando, FL
Active · expires Apr 7, 2027
CLIA Number10D2094029
Laboratory TypePhysician Office
Certificate Effective DateApril 8, 2025
Certificate Expiration DateApril 7, 2027
Laboratory DirectorTimothy E. Farley
Laboratory Phone(407) 930-7802
Laboratory LocationAdventhealth Imaging Lake Nona9975 Tavistock Lakes Blvd Ste 120, Orlando, FL 32827
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAYDEN RUNNELLS
Student in an Organized Health Care Education/Training Program
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-1126
MS. SARAH FATIMA KHAN
Student in an Organized Health Care Education/Training Program
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-1126
BRADLEY RICHEY
Student in an Organized Health Care Education/Training Program
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-3627
DR. MEIRELYS CASTRO M.D.
Family Medicine
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-3627
KATELYN GRACE WARNER
Student in an Organized Health Care Education/Training Program
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-1126
ISABELA BEATRIZ FUTURO DE LIMA
Student in an Organized Health Care Education/Training Program
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-1126
SANYA BANSAL
Student in an Organized Health Care Education/Training Program
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-1126
ROHIT VEERAPANENI
Student in an Organized Health Care Education/Training Program
9975 TAVISTOCK LAKES BLVD
ORLANDO, FL 32827
Orange County (407) 266-1126

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Florida Radiology Imaging At Lake Mary, LLC's NPI number?

The NPI number for Florida Radiology Imaging At Lake Mary, LLC is 1003208620. It was assigned to this organization in the NPPES registry on February 19, 2015. The provider is doing business as Adventhealth Imaging Lake Nona.

Where is Florida Radiology Imaging At Lake Mary, LLC located?

Florida Radiology Imaging At Lake Mary, LLC is located at 9975 Tavistock Lakes Blvd Suite 120, Orlando, FL 32827. The listed phone number is (407) 200-2865.

What is Florida Radiology Imaging At Lake Mary, LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Does Florida Radiology Imaging At Lake Mary, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2094029) is associated with this NPI, valid through April 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Florida Radiology Imaging At Lake Mary, LLC was last updated on February 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.