Provider Demographics
NPI:1326162470
Name:RADIATION ONCOLOGY SPECIALISTS LLC
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURSHED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-481-1687
Mailing Address - Street 1:2900 S HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-5612
Mailing Address - Country:US
Mailing Address - Phone:850-481-1687
Mailing Address - Fax:850-640-0761
Practice Address - Street 1:2900 S HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-5612
Practice Address - Country:US
Practice Address - Phone:850-481-1687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2018-05-31
Deactivation Date:2018-04-09
Deactivation Code:
Reactivation Date:2018-05-31
Provider Licenses
StateLicense IDTaxonomies
FLME875232085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71878OtherBCBS FLORIDA
FL267670200Medicaid
FLME87523OtherFLORIDA LICENSE
FL71878OtherBCBS FLORIDA
FL267670200Medicaid