MEDICARE: CENTER FOR RADIATION ONCOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician		FL

General Provider Information

NPI Number	:	1215935283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR RADIATION ONCOLOGY INC

Provider Business Mailing Address
First Line	:	407 N PARSONS AVE
Second Line	:	STE 103A
City	:	BRANDON
State	:	FL
Zip	:	33510-4537
Country	:	US
Telephone Number	:	813-657-9860
Fax Number	:	813-662-6536

Provider Business Practice Location Address
First Line	:	720 CORTARO DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6811
Country	:	US
Telephone Number	:	813-633-5513
Fax Number	:	813-633-4013

Authorized Official
Title or Position	:	PRES/CEO
Name	:	KATHRYN L KEPES
Credential	:	MD
Telephone Number	:	813-661-6339

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/21/2022

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