Organization
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHYAM B PARYANI MD (DIRECTOR)
(904) 309-8680
Entity
Organization
Contact information
Practice address
1677 EAGLE HARBOR PKWY, SUITE A, FLEMING ISLAND, FL 32003-4802
(904) 264-0004
(904) 264-0009
Mailing address
3599 UNIVERSITY BLVD S, SUITE 907, JACKSONVILLE, FL 32216-4252
(904) 309-8680
(904) 345-5841
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94980
BCBS
FL
Enumeration date
09/13/2013
Last updated
09/13/2013
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