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NPI Code Detail

MEDICARE: RAD ONC GROUP LLC

MEDICARE: RAD ONC GROUP LLC
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
12085R0001XRadiation Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

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

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Directions to “RAD ONC GROUP LLC ” Practice Location

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