Healthcare Provider Details

I. General information

NPI: 1528211752
Provider Name (Legal Business Name): ASSOCIATES IN CANCER CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13685 DOCTORS WAY SUITE 140
FORT MYERS FL
33912-4336
US

IV. Provider business mailing address

13685 DOCTORS WAY SUITE 140
FORT MYERS FL
33912-4336
US

V. Phone/Fax

Practice location:
  • Phone: 239-482-2288
  • Fax:
Mailing address:
  • Phone: 239-482-2288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME37410
License Number StateFL

VIII. Authorized Official

Name: DR. VANRAJSINH G RANA
Title or Position: PRESIDENT
Credential: MD
Phone: 239-482-2288