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NPI Code Detail

MEDICARE: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

MEDICARE: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0203XTherapeutic Radiology Physician
2207RH0000XHematology (Internal Medicine) Physician
3207RX0202XMedical Oncology Physician
42085R0202XDiagnostic Radiology Physician
5207RH0003XHematology & Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851409056
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
Provider Business Mailing Address
First Line : 4371 VERONICA S SHOEMAKER BLVD
Second Line : ATTN: CREDENTIAL DEPT
City : FORT MYERS
State : FL
Zip : 33916-2216
Country : US
Telephone Number : 239-274-8200
Fax Number : 239-278-3350
Provider Business Practice Location Address
First Line : 22395 EDGEWATER DR
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33980-2012
Country : US
Telephone Number : 941-766-7222
Fax Number : 941-766-1146
Authorized Official
Title or Position : PRESIDENT/MANAGING PARTNER
Name : DR. LUCIO NAVARRO GORDAN
Credential : MD
Telephone Number : 239-274-8200
Provider Enumeration Date : 08/28/2006
Last Update Date : 02/04/2019

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1528059227 — DR. VANCE M. WRIGHT-BROWNE M.D.
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1073571949 — DR. CHRISTOPHER F. LOBO MD
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1619053998 — DR. IVOR JOHN PERCENT M.D.
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1487852372 — MRS. MARY FRANCES SCOTT MSN ARNP
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1346567674 — MS. KAREN RUDOLPH APRN
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