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General NPI Number Information
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NPI Number | 1952303927
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Entity Type | Organization
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Legal Business Name | RADIATION ONCOLOGY GROUP, P.A.
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 4685 S CONGRESS AVE FIRST FLOOR
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City | LAKE WORTH
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State | FL
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Zip | 33461-4710
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Country | US
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Telephone | 561-964-2662
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Fax | 561-548-1635
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Provider Business Mailing Address
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Address Line | 4685 S CONGRESS AVE FIRST FLOOR
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City | LAKE WORTH
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State | FL
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Zip | 33461-4710
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Country | US
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Telephone | 561-964-2662
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Fax | 561-548-1635
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEROME J. SPUNBERG
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Credential | M.D.
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Telephone | 561-964-2662
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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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