Provider Demographics
NPI:1659003648
Name:NORTH FLORIDA RADIATION ONCOLOGY LLC
Entity Type:Organization
Organization Name:NORTH FLORIDA RADIATION ONCOLOGY LLC
Other - Org Name:HCA FLORIDA NORTH FLORIDA CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-333-5850
Mailing Address - Street 1:795 SW STATE ROAD 47
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-0453
Mailing Address - Country:US
Mailing Address - Phone:386-758-7822
Mailing Address - Fax:386-758-2224
Practice Address - Street 1:795 SW STATE ROAD 47
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0453
Practice Address - Country:US
Practice Address - Phone:386-758-7822
Practice Address - Fax:386-758-2224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH FLORIDA RADIATION ONCOLOGY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-28
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276396601Medicaid