Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Southeast Radiology Associates Pl

Diagnostic Radiology Physician in Lake City, FL · enumerated 2006 · authorized official John Detelich, Ceo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1467409631

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Registry record

Entity type Organization (Type 2)

Legal business name Southeast Radiology Associates Pl

Practice address 340 Nw Commerce Dr, Lake City, FL, 32055

Phone (386) 719-9000

Enumeration date May 31, 2006

Last updated in NPPES Oct 17, 2007

Taxonomy & classification

2085B0100X Body Imaging Physician Allopathic & Osteopathic Physicians Secondary

2085N0700X Neuroradiology Physician Allopathic & Osteopathic Physicians Secondary

2085N0904X Nuclear Radiology Physician Allopathic & Osteopathic Physicians Secondary

2085P0229X Pediatric Radiology Physician Allopathic & Osteopathic Physicians Secondary

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians Primary

2085R0204X Vascular & Interventional Radiology Physician Allopathic & Osteopathic Physicians Secondary

2085U0001X Diagnostic Ultrasound Physician Allopathic & Osteopathic Physicians Secondary

Authorized official

Name John Detelich

Title Ceo

Phone (850) 878-4127

Other identifiers

Identifier	Type	State	Issuer
97561	Other	FL	BCBS

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What type of organization is Southeast Radiology Associates Pl?

Southeast Radiology Associates Pl is registered in NPPES as a Diagnostic Radiology Physician (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-10-17.