NPI 1417715368

Billy Blake White, RARADIOLOGISTASS

Practitioner Radiology Practitioner Assistant Lakeland, FL

Practice location

Address: 1305 Lakeland Hills Blvd, Lakeland, FL 33805-4542
Phone: (863) 688-2334
Mailing address: 412 Bayou Rd, Winter Haven, FL 33884-2507

Registered specialties

Radiology Practitioner Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 243U00000X Licence RA63 (FL)

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Registry record

NPI: 1417715368
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Mar 2024
Record last updated: 6 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.