Provider Demographics
NPI:1295470177
Name:PROTON INTERNATIONAL CARE FOUNDATION - DELRAY LLC
Entity Type:Organization
Organization Name:PROTON INTERNATIONAL CARE FOUNDATION - DELRAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-649-4060
Mailing Address - Street 1:922 HAWKHORN CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4358
Mailing Address - Country:US
Mailing Address - Phone:630-649-4060
Mailing Address - Fax:312-896-9537
Practice Address - Street 1:5280 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6516
Practice Address - Country:US
Practice Address - Phone:561-323-6498
Practice Address - Fax:561-584-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation TherapyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center