Organization
FLORIDA ONCOLOGY NETWORK PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JAMES SOLLACCIO M.D. (PRESIDENT)
(407) 872-7786
Entity
Organization
Contact information
Practice address
1055 SAXON BLVD, ORANGE CITY, FL 32763-8468
(386) 917-5526
(386) 917-5553
Mailing address
PO BOX 1031, ORLANDO, FL 32802-1031
(407) 872-7786
(407) 872-3630
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME56371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24852F
MEDICARE SUFFIX
FL
Enumeration date
10/23/2007
Last updated
08/09/2012
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