21ST CENTURY ONCOLOGY OF JACKSONVILLE LLC


Address: 1235 San Marco Blvd, Suite 3, Jacksonville, FL 32207-8554
Phone: 9044935100

21ST CENTURY ONCOLOGY OF JACKSONVILLE LLC (NPI# 1215101902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215101902
Entity Type Organization
Organization Name 21ST CENTURY ONCOLOGY OF JACKSONVILLE LLC
Practice Address 1235 San Marco Blvd
Suite 3
Jacksonville
FL 32207-8554
Mailing Address 2234 Colonial Blvd
Fort Myers
FL 33907-1412
Practice Telephone 9044935100
Practice Fax Number 9044935130
Mailing Telephone 2399317342
Mailing Fax Number 2399317385
Enumeration Date 2008-04-15
Last Update Date 2011-01-05
Authorized Official Name DANIEL E. DOSORETZ (PRESIDENT/CEO)
Authorized Official Telephone 2399317275
Authorized Official Credential MD
Is Organization Subpart Y
Parent Organization Name RADIATION THERAPY SERVICES INC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2086X0206X Surgery
Specialization: Surgical Oncology
Allopathic & Osteopathic Physicians
Y 207RX0202X Internal Medicine
Specialization: Medical Oncology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 281173102 05
FL 281173101 05
FL 281173103 05
FL 281173100 05
FL 281173104 05

Office Location

Street Address 1235 SAN MARCO BLVD
SUITE 3
City JACKSONVILLE
State FL
Zip Code 32207-8554

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699762906 Robert Allen Joyce Internal Medicine 1235 San Marco Blvd, 3rd Floor, Jacksonville, FL 32207 2005-10-03
1962862466 Stephanie Palazzolo Physician Assistant 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 2016-02-26
1609286897 Baptist-southeast Gynecologic Oncology Inc Radiology 1235 San Marco Blvd, Suite 1, Jacksonville, FL 32207-8554 2014-04-28
1538593124 Baptist - Southeast Gynecologic Oncology Associates, Inc. Internal Medicine 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 2013-08-30
1548512056 Cancer Specialists LLC Durable Medical Equipment & Medical Supplies 1235 San Marco Blvd, Suite 202, Jacksonville, FL 32207-8554 2012-10-08
1871849034 Melinda Wheeley Fawbush Nurse Practitioner 1235 San Marco Blvd, #419, Jacksonville, FL 32207-8554 2012-07-25
1437331733 Nicole Sunderland Anderson Radiology 1235 San Marco Blvd, Suite 100, Jacksonville, FL 32207-8554 2007-11-29
1497956072 John Ho Vu Internal Medicine 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 2007-05-30
1477605962 Gerard A Coluccelli Md Pa Ophthalmology 1235 San Marco Blvd, 401, Jacksonville, FL 32207 2007-01-17
1427109248 Seth A Strope Urology 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 2007-01-16
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RX0202X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Medical Oncology

Taxonomy Definition

An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245519032 Carolina Healthcare Associates Inc Internal Medicine 221 Memorial Dr, Jacksonville, NC 28546-6333 2011-08-10
1558840264 Baptist-southeast Gynecologic Oncology Associates Inc Internal Medicine 14546 Old Saint Augustine Rd Ste 100, Jacksonville, FL 32258-5468 2018-08-13
1497956072 John Ho Vu Internal Medicine 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 2007-05-30
1821143710 Robert Zaiden Jr. Internal Medicine 1301 Palm Ave, Jacksonville, FL 32207-8432 2007-01-24
1669525333 Mohammad Asif Khan Internal Medicine 425 N Lee St Ste 204, Jacksonville, FL 32204 2007-01-18
1568413003 Janet R Hosenpud Internal Medicine 655 W 8th St, Ufjp Hematology-oncology Dept., Jacksonville, FL 32209-6511 2006-05-12
1306825989 Judith Kaur Internal Medicine 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2006-01-12
1629053558 William C Rupp Internal Medicine 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2005-12-14
1205825650 Kurt Alfred Jaeckle Internal Medicine 4500 San Pablo Rd S, Jacksonville, FL 32224 2005-10-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1568079648 The Oncology Institute Fl, LLC Internal Medicine 2105 W Watrous Ave, Tampa, FL 33606-3046 2020-09-23
1821626383 Tampa General Medical Group Inc Internal Medicine 17416 Brookside Trace Ct, Tampa, FL 33647-3589 2020-03-31
1770143752 Raul Vera-gimon Internal Medicine 10730 Nw 66th St Apt 312, Doral, FL 33178-3708 2019-06-20
1740748706 21st Century Oncology LLC Internal Medicine 3651 Fau Blvd Ste 100, Boca Raton, FL 33431-6489 2019-03-08
1699243501 Jose Armando Villamil Internal Medicine 8356 Sw 40th St Ste J, Miami, FL 33155-3356 2018-11-08
1790287878 South Florida Cancer Institute Internal Medicine 1005 Marina Mile Blvd, Fort Lauderdale, FL 33315-2433 2018-03-05
1912350596 Gilberto Lopes Internal Medicine 8345 Nw 66th St # 9886, Miami, FL 33195-2696 2016-07-19
1013382399 Neil Howard Love Internal Medicine 2 S Biscayne Blvd, Ste 3600, Miami, FL 33131-1806 2015-12-11
1790115681 Calvin Collins Jr. Internal Medicine 4403 Vineland Rd, Suite B5, Orlando, FL 32811 2013-11-14
1275895047 Ira D Stein Internal Medicine 19 Jewfish Ave, Key Largo, FL 33037-4711 2012-06-08
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Competitor

Search similar providers

City JACKSONVILLE
Zip Code 32207

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Dataset Information

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.

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