Organization
21ST CENTURY ONCOLOGY OF JACKSONVILLE LLC
Active
Parent organization
RADIATION THERAPY SERVICES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RADIATION THERAPY SERVICES INC
Authorized official
DANIEL E. DOSORETZ MD (PRESIDENT/CEO)
(239) 931-7275
Entity
Organization
Contact information
Practice address
1235 SAN MARCO BLVD, SUITE 3, JACKSONVILLE, FL 32207-8554
(904) 493-5100
(904) 493-5130
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
2086X0206X
Surgical Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281173100
—
FL
05
—
281173101
—
FL
05
—
281173102
—
FL
05
—
281173103
—
FL
05
—
281173104
—
FL
Enumeration date
04/15/2008
Last updated
01/05/2011
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