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General NPI Number Information
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NPI Number | 1649284076
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Entity Type | Organization
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Legal Business Name | RADIATION ONCOLOGY SPECIALISTS OF THE PALM BEACHES, L.L.C.
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 901 45TH ST KAPLAN CANCER CENTER
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2413
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Country | US
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Telephone | 561-881-2815
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Fax | 561-626-6146
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Provider Business Mailing Address
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Address Line | PO BOX 31477
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33420-1477
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Country | US
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Telephone | 561-626-7223
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Fax | 561-626-6146
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUNDERAM K SHETTY
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Credential | M.D.
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Telephone | 561-714-1397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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