Provider Demographics
NPI:1780666222
Name:RADIATION ONCOLOGY ASSOCIATES PL
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY ASSOCIATES PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INDER
Authorized Official - Middle Name:K
Authorized Official - Last Name:BHUTIANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-422-9831
Mailing Address - Street 1:PO BOX 144333
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-4333
Mailing Address - Country:US
Mailing Address - Phone:407-422-9831
Mailing Address - Fax:855-671-4753
Practice Address - Street 1:200 AVENUE F NE
Practice Address - Street 2:DEPT. OF RADIATION ONCOLOGY
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4131
Practice Address - Country:US
Practice Address - Phone:407-422-9831
Practice Address - Fax:863-291-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CG9564OtherRAILROAD MEDICARE
FL259282700Medicaid
CG9564OtherRAILROAD MEDICARE