Organization
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Active
Other names
Cancer 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
5742 BOOTH RD, SUITE A, JACKSONVILLE, FL 32207-5982
(904) 739-7779
(904) 739-7771
Mailing address
9143 PHILIPS HWY, 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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273427315
—
FL
01
—
94870
BCBS
FL
Enumeration date
10/03/2005
Last updated
05/24/2012
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