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General NPI Number Information
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NPI Number | 1699348268
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Entity Type | Organization
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Legal Business Name | CANCER SPECIALISTS, LLC
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 121 WHITEHALL DRIVE
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5266
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Country | US
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Telephone | 904-825-4500
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Fax | 904-825-3672
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Provider Business Mailing Address
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Address Line | 7751 BELFORT PKWY STE 350
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6951
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Country | US
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Telephone | 904-363-2113
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Fax | 904-363-2606
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Authorized Official
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Title or Position | CEO
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Name | ROBERT J PHELAN
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Credential |
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Telephone | 904-363-7442
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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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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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