Individual
JOHN FRANCIS REILLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-6000
(317) 705-5047
Mailing address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-6000
(317) 705-5047
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
9400615
NC
2085R0001X
Radiation Oncology Physician
Primary
ME143257
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205888
WELLCARE
FL
01
—
1220039
UNITED
SC
01
—
30246444
SELECT HEALTH MEDICAID LINE
SC
01
—
5074302
AETNA
SC
01
—
5290539
CIGNA
SC
01
—
80067958
SELECT HEALTH
SC
05
—
8971181
—
NC
01
—
P01604823
RR MEDICARE
SC
05
—
Q0061W
—
SC
Enumeration date
06/06/2006
Last updated
02/19/2020
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