| NPI | 1467491993 |
|---|---|
| Doing Business As | LAKESIDE OPEN MRI OF TAVARES |
| Entity Type | Organization |
| Authorized Contact | SHAUN P WOODBURN President 352-742-9211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: FL HCC5152) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-08-22 |