Provider Demographics
NPI:1548431422
Name:ASCENT CYBERKNIFE LLC
Entity Type:Organization
Organization Name:ASCENT CYBERKNIFE LLC
Other - Org Name:CYBERKNIFE OF THE TREASURE COAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP- OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAINIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-486-5127
Mailing Address - Street 1:2100 SE OCEAN BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3332
Mailing Address - Country:US
Mailing Address - Phone:772-223-9130
Mailing Address - Fax:772-223-9120
Practice Address - Street 1:2111 SE OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3305
Practice Address - Country:US
Practice Address - Phone:772-223-9130
Practice Address - Fax:772-223-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation