Provider Demographics
NPI:1447360946
Name:SOUTH FLORIDA RADIATION ONCOLOGY LLC
Entity type:Organization
Organization Name:SOUTH FLORIDA RADIATION ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPURANENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-775-7075
Mailing Address - Street 1:3355 BURNS RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4353
Mailing Address - Country:US
Mailing Address - Phone:561-775-7075
Mailing Address - Fax:561-795-1030
Practice Address - Street 1:3355 BURNS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4353
Practice Address - Country:US
Practice Address - Phone:561-775-7075
Practice Address - Fax:561-775-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty