INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC (NPI# 1043230402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043230402 |
| Entity Type | Organization |
| Organization Name | INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC |
| Other Organization Name | FLORIDA RADIATION ONCOLOGY GROUP |
| Practice Address |
5742 Booth Rd Suite B Jacksonville FL 32207-5982 |
| Mailing Address |
Po Box 19675 Jacksonville FL 32245-9675 |
| Practice Telephone | 9046366911 |
| Practice Fax Number | 9046366330 |
| Mailing Telephone | 9043098680 |
| Mailing Fax Number | 9043455847 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-01-21 |
| Authorized Official Name | SHYAM B PARYANI (DIRECTOR) |
| Authorized Official Telephone | 9043098680 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 273427316 | 05 | |
| FL | BCBS | 94890 | 01 |
| FL | RAILROAD MEDICARE | DC6938 | 01 |
| Other Name | Type Code |
|---|---|
| Florida Radiation Oncology Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023054921 | Integrated Community Oncology Network LLC | Internal Medicine | 1689 Eagle Harbor Pkwy, Suite C, Orange Park, FL 32003-4817 | 2006-06-21 |
| 1932196243 | Integrated Community Oncology Network LLC | Internal Medicine | 9143 Philips Hwy, Ste 560, Jacksonville, FL 32256-1348 | 2005-10-03 |
| 1730176017 | Integrated Community Oncology Network LLC | Durable Medical Equipment & Medical Supplies | 600 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2005-10-03 |
| 1821085101 | Integrated Community Oncology Network LLC | Durable Medical Equipment & Medical Supplies | 2161 Kingsley Avenue, Suite 200, Orange Park, FL 32073 | 2005-10-03 |
| 1558796151 | Integrated Community Oncology Network LLC | Internal Medicine | 1677 Eagle Harbor Pkwy, Suite A, Fleming Island, FL 32003-4802 | 2013-09-13 |
| 1649574500 | Integrated Community Oncology Network LLC | Urology | 6269 Beach Blvd, Suite 2, Jacksonville, FL 32216-2768 | 2011-01-06 |
| 1720310733 | Integrated Community Oncology Network LLC | Urology | 1715 Village Way, Orange Park, FL 32073-5263 | 2010-02-02 |
| 1467683839 | Integrated Community Oncology Network LLC | Radiology | 425 S Parsons Ave, Suite 102, Brandon, FL 33511-5289 | 2009-08-04 |
| 1407096183 | Integrated Community Oncology Network LLC | Radiology | 710 Lomax St, Suite 1, Jacksonville, FL 32204-4004 | 2009-02-20 |
| 1457529786 | Integrated Community Oncology Network LLC | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2008-02-20 |
| Street Address |
5742 BOOTH RD SUITE B |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-5982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306841622 | Jaswant S Jadeja | Internal Medicine | 5742 Booth Rd, Jacksonville, FL 32207-5905 | 2005-06-14 |
| 1396176111 | Angela Irene Mays | Nurse Practitioner | 5742 Booth Rd, Suite A, Jacksonville, FL 32207-5982 | 2013-12-04 |
| 1801148473 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 5742 Booth Rd, Suite A, Jacksonville, FL 32207-5982 | 2012-10-08 |
| 1023389806 | Meredith Hughes Harlow | Social Worker | 5742 Booth Rd, Suite A, Jacksonville, FL 32207-5982 | 2012-01-25 |
| 1790935153 | Bijoy Pankaj Telivala | Internal Medicine | 5742 Booth Rd, Suite A, Jacksonville, FL 32207-5982 | 2008-09-23 |
| 1568619716 | Kelli K Colson | Nurse Practitioner | 5742 Booth Rd, Jacksonville, FL 32207-5982 | 2008-08-19 |
| 1588724033 | Memorial Southside Cancer Center LLC | Clinic/Center | 5742 Booth Rd, Suite B, Jacksonville, FL 32207 | 2006-12-12 |
| 1245345438 | Aref A Badr | Nuclear Medicine | 5742 Booth Rd, Ste B, Jacksonville, FL 32207-5982 | 2006-08-20 |
| 1093752826 | Sejal S Kuthiala | Internal Medicine | 5742 Booth Rd, Suite A, Jacksonville, FL 32207-5982 | 2006-06-01 |
| 1508824608 | Larry H Wilf | Specialist | 5742 Booth Rd, Suite B, Jacksonville, FL 32207-5982 | 2006-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033544390 | Florida Physician Specialists LLC | Radiology | 7017 A C Skinner Pkwy, Jacksonville, FL 32256-6932 | 2013-09-05 |
| 1962662775 | Curtis Michael Bryant | Radiology | 2015 Jefferson Street, University of Florida Proton Institute, Jacksonville, FL 32206 | 2008-06-15 |
| 1275791055 | Bradford Scott Hoppe | Radiology | 4500 San Pablo Rd, Jacksonville, FL 32224 | 2008-05-28 |
| 1023282456 | Jacksonville Radiation Therapy Services LLC | Radiology | 7751 Baymeadows Road E, Jacksonville, FL 32256 | 2008-04-16 |
| 1033213038 | Jacksonville Oncology Institute Limited | Radiology | 567 N Westgate Ave, Jacksonville, IL 62650-1156 | 2006-09-11 |
| 1689630949 | Mark Emerson Augspurger | Radiology | 14546 Old Saint Augustine Rd Ste 105, Jacksonville, FL 32258-5469 | 2006-04-25 |
| 1245296904 | Ahmed M Akl | Radiology | 7015 A C Skinner Pkwy Bldg 100, Jacksonville, FL 32256-6932 | 2006-04-21 |
| 1649231291 | Randal Hollis Henderson | Radiology | 2015 N. Jefferson St., Jacksonville, FL 32206 | 2006-03-31 |
| 1679555270 | Romaine Charles Nichols Jr. | Radiology | 2015 Jefferson St, Jacksonville, FL 32206-3531 | 2005-11-18 |
| 1972508299 | Paul B Ossi | Radiology | 10881 San Jose Blvd, Jacksonville, FL 32223-6612 | 2005-06-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.