1730296229 NPI number — RADIATION ONCOLOGY CENTERS OF SOUTHWEST FLORIDA LLC

Table of content: DR. VIRGINIA H. PALAZZO M.D. (NPI 1053309682)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730296229 NPI number — RADIATION ONCOLOGY CENTERS OF SOUTHWEST FLORIDA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RADIATION ONCOLOGY CENTERS OF SOUTHWEST FLORIDA LLC
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:
Provider Other Organization Name Type Code:
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:
1730296229
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1450
Provider Second Line Business Mailing Address:
NW 5469
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55485-5469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-795-2270
Provider Business Mailing Address Fax Number:
941-795-7995

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6215 21ST AVE W
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BRADENTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34209-7819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-795-2270
Provider Business Practice Location Address Fax Number:
941-795-7995
Provider Enumeration Date:
08/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
TRI
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
941-795-2270

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  L06000059070 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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