Organization
CCCNF - LAKE BUTLER, LLC
Active
Other names
FL Dept of Corrections - RMC Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STUART M. BITTING (EVP)
(615) 783-1253
Entity
Organization
Contact information
Practice address
7765 S COUNTY ROAD 231, LAKE BUTLER, FL 32054-5721
(386) 496-0900
(386) 496-0777
Mailing address
104 WOODMONT BLVD, SUITE 500, NASHVILLE, TN 37205-2245
(615) 467-7400
(615) 467-7401
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
JR45707000
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RAM LICENSE 4226-1
RADIOACTIVE MATERIAL LICENSE
FL
Enumeration date
03/15/2016
Last updated
03/15/2016
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