PHYSICIANS FOR A COMMUNITY UNITED FOR RESEARCH AND EDUCATION LLC (NPI# 1770739104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770739104 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS FOR A COMMUNITY UNITED FOR RESEARCH AND EDUCATION LLC |
| Practice Address |
795 Sw State Road 47 Lake City FL 32025-0453 |
| Mailing Address |
3599 University Blvd S Ste 1000 Jacksonville FL 32216-4280 |
| Practice Telephone | 3867587822 |
| Practice Fax Number | 3867582224 |
| Mailing Telephone | 9043463338 |
| Mailing Fax Number | 9043460815 |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2009-07-14 |
| Authorized Official Name | SHYAM B PARYANI (PRESIDENT) |
| Authorized Official Telephone | 9043463338 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE | DO8891 | 01 |
| FL | BCBS OF FL | 33201 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578869392 | Physicians for A Community United for Research and Education LLC | Radiology | 7315 Green Slope Dr, Zephyrhills, FL 33541-1314 | 2011-01-27 |
| 1740586460 | Physicians for A Community United for Research and Education LLC | Radiology | 3650 Emergency Ln, Sebring, FL 33870-5534 | 2011-01-27 |
| 1891099032 | Physicians for A Community United for Research and Education LLC | Radiology | 717 W Robertson St, Brandon, FL 33511-4921 | 2011-01-03 |
| 1134433006 | Physicians for A Community United for Research and Education LLC | Radiology | 3201 Sw 33rd Rd, Ocala, FL 34474-7459 | 2010-08-03 |
| 1205152808 | Physicians for A Community United for Research and Education LLC | Radiology | 6420 W Newberry Rd, Gainesville, FL 32605-4308 | 2010-04-08 |
| 1770721466 | Physicians for A Community United for Research and Education LLC | Internal Medicine | 2003 Centre Pointe Blvd, Tallahassee, FL 32308-4893 | 2009-02-03 |
| Street Address |
795 SW STATE ROAD 47 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025-0453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982892550 | Vernon Montoya Md Pa | Internal Medicine | 795 Sw State Road 47, Lake City, FL 32025-0453 | 2007-10-09 |
| 1306405816 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 795 Sw State Road 47, Lake City, FL 32025-0453 | 2019-06-08 |
| 1760817175 | Brielle L Brown | Nurse Practitioner | 795 Sw State Road 47, Lake City, FL 32025-0453 | 2013-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| 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 |
|---|---|---|---|---|
| 1902893902 | North Florida Cancer Center Lake City LLC | Radiology | 795 Sw Highway 47, Lake City, FL 32025 | 2005-10-04 |
| 1487646030 | Mark Edmund Thompson | Radiology | 4520 W Us Highway 90, Lake City, FL 32055-8341 | 2005-08-19 |
| 1114467586 | Carolinas Medical Alliance Inc | Radiology | 148 Sauls St, Suite F, Lake City, SC 29560-2677 | 2017-03-03 |
| 1467434654 | Martin I. Holzman | Radiology | 4520 W Us Highway 90, Lake City, FL 32055-8341 | 2005-11-15 |
| 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 | ||||
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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.