Organization
CENTER FOR RADIATION ONCOLOGY OF TAMPA BAY IN
Active
Other names
Center for Radiation Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK L HERNANDEZ MBA, FACHE (VP INDIANA AND SOUTH FLORIDA OPERAI)
(813) 662-6024
Entity
Organization
Contact information
Practice address
717 W ROBERTSON ST, BRANDON, FL 33511-4921
(813) 661-6339
(813) 661-6442
Mailing address
2715 WEST VIRGINIA AVENUE, TAMPA, FL 33607-6327
(813) 662-6024
(813) 514-1257
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
27091
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264462200
—
FL
Enumeration date
07/01/2005
Last updated
11/01/2012
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