Provider Demographics
NPI:1457493512
Name:RADIATION ONCOLOGY GROUP
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-843-3080
Mailing Address - Street 1:PO BOX 800967
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0967
Mailing Address - Country:US
Mailing Address - Phone:787-843-3080
Mailing Address - Fax:787-259-1585
Practice Address - Street 1:PONCE BY PASS 107
Practice Address - Street 2:STE 105 PARRA BLDG
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-843-3080
Practice Address - Fax:787-259-1585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty