Provider Demographics
NPI:1013018860
Name:AMERICAN RADIATION ONCOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:AMERICAN RADIATION ONCOLOGY ASSOCIATES INC
Other - Org Name:OCALA COMMUNITY CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAYANTH
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-291-2495
Mailing Address - Street 1:3201 SW 33RD RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7459
Mailing Address - Country:US
Mailing Address - Phone:352-291-2495
Mailing Address - Fax:352-291-2498
Practice Address - Street 1:3201 SW 33RD RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7459
Practice Address - Country:US
Practice Address - Phone:352-291-2495
Practice Address - Fax:352-291-2498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
FLME00654652085R0001X
FLME00852002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1779Medicare PIN