1740201912 NPI number — NORTH FLORIDA RADIATION ONCOLOGY LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740201912 NPI number — NORTH FLORIDA RADIATION ONCOLOGY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH FLORIDA RADIATION ONCOLOGY 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:
6
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:
1740201912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6420 W NEWBERRY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32605-6621
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-333-5840
Provider Business Mailing Address Fax Number:
352-333-5841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6420 W NEWBERRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32605-6621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-333-5840
Provider Business Practice Location Address Fax Number:
352-333-5841
Provider Enumeration Date:
07/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
352-333-5850

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 276396600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97370 . This is a "BCBS OF FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: DF3627 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 276396600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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