Provider Demographics
NPI:1659349033
Name:NORTH FLORIDA RADIATION ONCOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:NORTH FLORIDA RADIATION ONCOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIATION ONCOLOGIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:V
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-431-5255
Mailing Address - Street 1:PO BOX 14446
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-4446
Mailing Address - Country:US
Mailing Address - Phone:850-222-4858
Mailing Address - Fax:850-222-1252
Practice Address - Street 1:1775 ONE HEALING PL
Practice Address - Street 2:TMH CANCER CENTER
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4600
Practice Address - Country:US
Practice Address - Phone:850-431-5255
Practice Address - Fax:850-431-6591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40348OtherBCBS GROUP
FL379111400Medicaid
FL40348OtherBCBS GROUP