Organization
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Active
Other names
Florida Radiation Oncology Group
Organization subpart
No
Provider details
NPI number
Authorized official
SHYAM B PARYANI MD (DIRECTOR)
(904) 309-8680
Entity
Organization
Contact information
Practice address
14546 SAINT AUGUSTINE RD, SUITE 105, JACKSONVILLE, FL 32258-5468
(904) 271-6890
(904) 271-6695
Mailing address
PO BOX 19675, JACKSONVILLE, FL 32245-9675
(904) 309-8680
(904) 345-5841
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273427319
—
FL
01
—
94890
BLUE CROSS BLUE SHIELD
FL
01
—
DC6938
MEDICARE RAILROAD
FL
Enumeration date
07/12/2006
Last updated
07/31/2012
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