Provider Demographics
NPI:1831622299
Name:AMERICAN ONCOLOGY NETWORK LLC
Entity type:Organization
Organization Name:AMERICAN ONCOLOGY NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-274-8200
Mailing Address - Street 1:9160 FORUM CORPORATE PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-7805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9160 FORUM CORPORATE PKWY
Practice Address - Street 2:SUITE 350
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7805
Practice Address - Country:US
Practice Address - Phone:239-262-8502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty