Provider Demographics
NPI:1871555946
Name:NAPLES RADIATION ONCOLOGY, P.A.
Entity type:Organization
Organization Name:NAPLES RADIATION ONCOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIATION ONCOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-262-5168
Mailing Address - Street 1:2575 NORTHBROOKE PLAZA DR UNIT 207
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8099
Mailing Address - Country:US
Mailing Address - Phone:239-262-5168
Mailing Address - Fax:239-262-8524
Practice Address - Street 1:2575 NORTHBROOKE PLAZA DR UNIT 207
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8099
Practice Address - Country:US
Practice Address - Phone:239-262-5168
Practice Address - Fax:239-262-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057715400Medicaid
FL256919100Medicaid
FL256919100Medicaid
FL057715400Medicaid
FLE11318Medicare UPIN
FL17785AMedicare ID - Type Unspecified
FLK1016Medicare ID - Type UnspecifiedMEDICARE GROUP #
FL370777600Medicaid