Organization
INTEGRATED COMMUNITY ONCOLOGY NETWORK LLC
Active
Other names
Urology Associates of Northeast Florida
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J PHELAN (EXECUTIVE DIRECTOR)
(904) 363-2113
Entity
Organization
Contact information
Practice address
1715 VILLAGE WAY, ORANGE PARK, FL 32073-5263
(904) 264-8418
(904) 264-9692
Mailing address
9143 PHILIPS HWY STE 560, JACKSONVILLE, FL 32256-1369
(904) 363-7453
(904) 538-3672
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME59868
FL
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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