INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC (NPI# 1407096183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407096183 |
Entity Type | Organization |
Organization Name | INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC |
Other Organization Name | FLORIDA RADIATION ONCOLOGY GROUP |
Practice Address |
710 Lomax St Suite 1 Jacksonville FL 32204-4004 |
Mailing Address |
Po Box 19675 Jacksonville FL 32245-9675 |
Practice Telephone | 9044832310 |
Practice Fax Number | 9044832313 |
Mailing Telephone | 9043098680 |
Mailing Fax Number | 9043455841 |
Enumeration Date | 2009-02-20 |
Last Update Date | 2012-07-31 |
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 | 273427327 | 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 |
1457529786 | Integrated Community Oncology Network LLC | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2008-02-20 |
1225234404 | Integrated Community Oncology Network LLC | Radiology | 200 N Mangoustine Ave, Sanford, FL 32771-1017 | 2007-06-25 |
Street Address |
710 LOMAX ST SUITE 1 |
City | JACKSONVILLE |
State | FL |
Zip Code | 32204-4004 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154396695 | Shannon Marie Cordes | Nurse Practitioner | 710 Lomax St, Jacksonville, FL 32204-4004 | 2006-02-20 |
1740741495 | Michael Wilson | Nurse Practitioner | 710 Lomax St, Jacksonville, FL 32204-4015 | 2019-03-26 |
1003254228 | Kyle Hollingsworth | Specialist/Technologist | 710 Lomax St, Jacksonville, FL 32204-4015 | 2013-06-10 |
1700129707 | Matthew Alan Nielsen | Urology | 710 Lomax St, Jacksonville, FL 32204 | 2013-03-28 |
1619221637 | Florida Physician Specialists LLC | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2012-10-29 |
1588917108 | Florida Physician Specialists LLC | Radiology | 710 Lomax St, Suite 1, Jacksonville, FL 32204-4004 | 2012-10-19 |
1114224961 | Tara A Romeu | Physician Assistant | 710 Lomax St, Jacksonville, FL 32204-4015 | 2011-02-14 |
1457529786 | Integrated Community Oncology Network LLC | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2008-02-20 |
1770604548 | Sagar R. Shah | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2007-04-02 |
1548301336 | James Atherton Baldock | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2007-02-12 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
Find all providers in zip 32204 |
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 | 32204 |
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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.