Organization
FLORIDA PROTON THERAPY INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY MEDENHALL MD (DIRECTOR, ACTIVE, ATTENDING)
(904) 588-1401
Entity
Organization
Contact information
Practice address
2015 JEFFERSON ST, JACKSONVILLE, FL 32206-3531
(904) 588-1263
(904) 588-1300
Mailing address
2015 JEFFERSON ST, JACKSONVILLE, FL 32206-3531
(904) 588-1401
(904) 588-1437
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME39054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2771470 00
—
FL
Enumeration date
05/18/2006
Last updated
12/05/2024
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