1578667291 NPI number — AMERICAN RADIATION ONCOLOGY ASSOCIATES, INC

Table of content: (NPI 1578667291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578667291 NPI number — AMERICAN RADIATION ONCOLOGY ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN RADIATION ONCOLOGY ASSOCIATES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CANCER TREATMENT CENTER OF THE NATURE COAST
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578667291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3201 SW 33RD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34474-7459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-291-2495
Provider Business Mailing Address Fax Number:
352-291-2498

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3406 N LECANTO HWY
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34465-3548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-291-2495
Provider Business Practice Location Address Fax Number:
352-291-2498
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RAO
Authorized Official First Name:
JAYANTH
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
352-291-3495

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: ME0065465 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0001X , with the licence number: ME0085200 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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