Provider Demographics
NPI:1407045842
Name:GULF REGION RADIATION ONCOLOGY CENTERS INC
Entity Type:Organization
Organization Name:GULF REGION RADIATION ONCOLOGY CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-416-1791
Mailing Address - Street 1:1545 AIRPORT BLVD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8615
Mailing Address - Country:US
Mailing Address - Phone:850-416-6700
Mailing Address - Fax:850-416-7770
Practice Address - Street 1:1545 AIRPORT BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8615
Practice Address - Country:US
Practice Address - Phone:850-416-6700
Practice Address - Fax:850-416-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty