Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southeast Radiology Associates Pl

Organization Body Imaging Physician · NPI 1467409631

Southeast Radiology Associates Pl is a Body Imaging Physician in Lake City, Florida. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
7

Practice location Address checks out

340 NW Commerce Dr
Lake City, FL 32055-4709
Phone: (386) 719-9000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X
Body Imaging Physician Taxonomy 2085B0100X
Neuroradiology Physician Taxonomy 2085N0700X
Nuclear Radiology Physician Taxonomy 2085N0904X
Pediatric Radiology Physician Taxonomy 2085P0229X
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X
Diagnostic Ultrasound Physician Taxonomy 2085U0001X

Record details

NPI number1467409631
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Detelich — Ceo · (850) 878-4127
NPI enumeratedMay 31, 2006
Last updated in NPPESOctober 17, 2007
Mailing addressPo Box 2293, Lake City, FL 32056-2293