Organization
PHYSICIANS FOR A COMMUNITY UNITED FOR RESEARCH AND EDUCATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHYAM B PARYANI M.D. (PRESIDENT)
(904) 346-3338
Entity
Organization
Contact information
Practice address
795 SW STATE ROAD 47, LAKE CITY, FL 32025-0453
(386) 758-7822
(386) 758-2224
Mailing address
3599 UNIVERSITY BLVD S STE 1000, JACKSONVILLE, FL 32216-4280
(904) 346-3338
(904) 346-0815
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
207U00000X
Nuclear Medicine Physician
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33201
BCBS OF FL
FL
01
—
DO8891
RR MEDICARE
FL
Enumeration date
08/18/2008
Last updated
07/14/2009
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