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General NPI Number Information
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NPI Number | 1346322724
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Entity Type | Organization
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Legal Business Name | RAD ONC GROUP LLC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 5550 S US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34982-8701
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Country | US
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Telephone | 772-464-8862
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 880429
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City | FORT PIERCE
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State | FL
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Zip | 34988-0429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. RAMESH KUMAR
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Credential | M.D.
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Telephone | 772-464-8862
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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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