Healthcare Provider Details

I. General information

NPI: 1790054872
Provider Name (Legal Business Name): FLORIDA CANCER AFFILIATES PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11373 CORTEZ BLVD SUITE 200
BROOKSVILLE FL
34613-5414
US

IV. Provider business mailing address

11373 CORTEZ BLVD SUITE 200
BROOKSVILLE FL
34613-5414
US

V. Phone/Fax

Practice location:
  • Phone: 352-597-4998
  • Fax: 352-596-6051
Mailing address:
  • Phone: 352-597-4998
  • Fax: 352-596-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GERALD J. ROBBINS
Title or Position: PRACTICE PRESIDENT
Credential: M.D.
Phone: 727-484-7722