Organization
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Active
Other names
Cancer Care Specialists of North Florida
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT PHELAN (CEO)
(904) 363-2113
Entity
Organization
Contact information
Practice address
9 SAN BARTOLA DR, ST AUGUSTINE, FL 32086-5767
(904) 825-4500
(904) 825-3672
Mailing address
9143 PHILIPS HWY, STE 560, JACKSONVILLE, FL 32256-1348
(904) 363-2113
(904) 538-3672
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273427309
—
FL
01
—
94890
BCBS
FL
Enumeration date
10/03/2005
Last updated
05/24/2012
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