INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC (NPI# 1760417042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760417042 |
| Entity Type | Organization |
| Organization Name | INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC |
| Other Organization Name | FLORIDA RADIATION ONCOLOGY GROUP |
| Practice Address |
1375 Roberts Dr Suite 100 Jacksonville Beach FL 32250-3210 |
| Mailing Address |
Po Box 19675 Jacksonville FL 32245-9675 |
| Practice Telephone | 9042420166 |
| Practice Fax Number | 9042420167 |
| Mailing Telephone | 9043098680 |
| Mailing Fax Number | 9043455847 |
| Enumeration Date | 2006-07-12 |
| 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 | 273427305 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 94890 | 01 |
| FL | MEDICARE RAILROAD | 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 |
1375 ROBERTS DR SUITE 100 |
| City | JACKSONVILLE BEACH |
| State | FL |
| Zip Code | 32250-3210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245768 | Thomas G Gaddis | Internal Medicine | 1375 Roberts Dr, Suite 103, Jacksonville Beach, FL 32250-3210 | 2005-06-14 |
| 1659506319 | Ilicia Lauren Shugarman | Internal Medicine | 1375 Roberts Dr, Suite 103, Jacksonville Beach, FL 32250-3210 | 2009-05-26 |
| 1396949954 | Joe E Gerges El Khoury | Internal Medicine | 1375 Roberts Dr, Suite 204, Jacksonville Beach, FL 32250-3210 | 2007-06-14 |
| 1093722647 | Shirley Lynn Fabrizio | Nurse Practitioner | 1375 Roberts Dr, Suite 103, Jacksonville Beach, FL 32250-3210 | 2006-08-02 |
| 1053362723 | Michael B Ibach | Internal Medicine | 1375 Roberts Dr, Ste 204, Jacksonville Beach, FL 32250-3210 | 2006-05-15 |
| 1780641464 | Walter Phelps Scott | Specialist | 1375 Roberts Dr, Suite 100, Jacksonville Beach, FL 32250-3210 | 2006-04-27 |
| 1881684454 | John Theodore Woeste Jr. | Anesthesiology | 1375 Roberts Dr, Suite 205, Jacksonville Beach, FL 32250-3210 | 2005-10-25 |
| 1073501805 | Michelle M Krawczyk | Nurse Practitioner | 1375 Roberts Dr, Suite 103, Jacksonville Beach, FL 32250-3210 | 2005-10-06 |
| 1467449785 | Integrated Community Oncology Network LLC | Internal Medicine | 1375 Roberts Dr, Ste 103, Jacksonville Beach, FL 32250-3210 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386129591 | Kelsey Ilene Keimig | Audiologist | 3200 S 3rd Street, Ste 101, Jacksonville, FL 32250 | 2018-10-03 |
| 1225529696 | Turning Tides Eating Disorder Treatment Center, LLC. | Clinic/Center | 4300 Marsh Landings Blvd. #101, Jacksonville Beach, FL 32250 | 2018-05-22 |
| 1528578820 | Dianne Frances Gay | Dental Hygienist | 1144 14th Street North, Jacksonville Beach, FL 32250 | 2017-10-02 |
| 1801324280 | Kailo Nutrition | Dietitian, Registered | 353 B 6th Street South, Jacksonville, FL 32250 | 2017-05-30 |
| 1275985368 | Shankeertha Sundaralingam | Dentist | 3316 3rd St S Ste 101, Jacksonville Beach, FL 32250 | 2016-07-13 |
| 1851777494 | Brooke Worthington Davidson | Audiologist | 1370 13th Ave S Ste 115, Jacksonville Beach, FL 32250 | 2015-08-05 |
| 1689059115 | Jenna Levine | Speech-Language Pathologist | 779 10th Avenue South, Jacksonville Beach, FL 32250 | 2015-07-27 |
| 1790176824 | Olivia Ingram Caswell | Acupuncturist | 2902 Isabella Boulevard, Suite 50, Jacksonville Beach, FL 32250 | 2015-02-11 |
| 1467859033 | Colleen Freeman | Physical Therapist | 1537 Penman Rd, Jacksonville, FL 32250 | 2014-11-26 |
| 1356750012 | Madelyn Jones | Physical Therapist | 1320 Roberts Drive, Jacksonville Beach, FL 32250 | 2014-08-07 |
| Find all providers in zip 32250 | ||||
| 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 |
|---|---|---|---|---|
| 1114539079 | Mydoctoreb LLC | Radiology | 17407 Lotino Pl, Lutz, FL 33548-4815 | 2020-08-20 |
| 1417516600 | Arthur J. Iglesias, M.d. P.a. | Radiology | 1100 N.w. 95th Street, Cancer Center, Miami, FL 33150 | 2019-06-11 |
| 1962970111 | William A Assad, M.d. | Radiology | 3202 Henderson Blvd Ste 204a, Tampa, FL 33609-3043 | 2018-11-06 |
| 1508361361 | Marian Ingram | Radiology | 350 Nw 84th Ave Ste 102, Plantation, FL 33324-1820 | 2018-03-26 |
| 1376051870 | Indian River Health Services Inc | Radiology | 3555 10th Ct Ste 101, Vero Beach, FL 32960-5013 | 2018-01-18 |
| 1417492497 | Flagler Hospital, Inc. | Radiology | 97 Health Park Blvd, Saint Augustine, FL 32086-5777 | 2016-12-29 |
| 1447614441 | Benjamin Spieler | Radiology | 1475 Nw 12th Ave # Sccc1500, Miami, FL 33136-1002 | 2016-04-06 |
| 1629461371 | Florida Oncology Tavares, LLC | Radiology | 2010 Nightingale Ln, Tavares, FL 32778-4361 | 2015-03-05 |
| 1285042036 | Gulf Region Radiation Oncology Centers | Radiology | 1545 Airport Blvd Ste 1000, Pensacola, FL 32504-8615 | 2014-07-24 |
| 1962812917 | Florida Oncology Partners LLC | Radiology | 1100 N.w. 95 Street, Cancer Center, Miami, FL 33150-2038 | 2014-04-29 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE BEACH |
| Zip Code | 32250 |
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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.