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General NPI Number Information
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NPI Number | 1003879099
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Entity Type | Organization
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Legal Business Name | RADIATION ONCOLOGY ASSOCIATES OF CENTRAL FLORIDA,PA
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 303 N CLYDE MORRIS BLVD ROC GROUND FLOOR
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2709
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Country | US
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Telephone | 386-254-4220
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Fax | 386-258-4995
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | DAYTONA BEACH
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State | FL
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Zip | 32115-1089
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Country | US
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Telephone | 386-254-4220
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Fax | 386-258-4995
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Authorized Official
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Title or Position | PRESIDENT
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Name | THEODORE E YAEGER IV
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Credential | M.D.
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Telephone | 386-254-4220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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