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NPI Code Detail

MEDICARE: FLORIDA PROTON THERAPY INSTITUTE INC

MEDICARE: FLORIDA PROTON THERAPY INSTITUTE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology PhysicianME39054FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891748257
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA PROTON THERAPY INSTITUTE INC
Provider Business Mailing Address
First Line : 2015 JEFFERSON ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32206-3531
Country : US
Telephone Number : 904-588-1401
Fax Number : 904-588-1437
Provider Business Practice Location Address
First Line : 2015 JEFFERSON ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32206-3531
Country : US
Telephone Number : 904-588-1263
Fax Number : 904-588-1300
Authorized Official
Title or Position : DIRECTOR, ACTIVE, ATTENDING
Name : NANCY MEDENHALL
Credential : MD
Telephone Number : 904-588-1401
Provider Enumeration Date : 05/18/2006
Last Update Date : 12/05/2024

Similar Medicare Providers

1114874898 — HARDEV GREWAL
Practice Location Address:
2015 JEFFERSON ST
JACKSONVILLE, FL
32206-3531
Practice Phone: 904-588-1800
Practice Fax:
1679555270 — DR. ROMAINE CHARLES NICHOLS JR. M.D.
Practice Location Address:
2015 JEFFERSON ST
JACKSONVILLE, FL
32206-3531
Practice Phone: 904-588-1800
Practice Fax:
1649230301 — MS. TEENA MARIA BURCHIANTI ARNP
Practice Location Address:
2015 JEFFERSON ST
JACKSONVILLE, FL
32206-3531
Practice Phone: 904-588-1800
Practice Fax: 904-588-1300
1407817927 — DR. NANCY P. MENDENHALL MD
Practice Location Address:
2015 JEFFERSON ST
JACKSONVILLE, FL
32206-3531
Practice Phone: 904-588-1263
Practice Fax:
1356431688 — DANIEL J INDELICATO MD
Practice Location Address:
2015 JEFFERSON ST
JACKSONVILLE, FL
32206-3531
Practice Phone: 904-588-1263
Practice Fax:
1952508491 — DR. ROI DAGAN M.D.
Practice Location Address:
2015 JEFFERSON ST , UNIVERSITY OF FLORIDA PROTON THERAPY INSTITUTE
JACKSONVILLE, FL
32206-3531
Practice Phone: 904-588-1800
Practice Fax: 904-588-1300

Directions to “FLORIDA PROTON THERAPY INSTITUTE INC ” Practice Location

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