| NPI | 1912406984 |
|---|---|
| Doing Business As | LAKELAND VASCULAR INSTITUTE OUTPATIENT CENTER |
| Entity Type | Organization |
| Authorized Contact | EDWARD J GOODEMOTE CEO 863-577-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |