Healthcare Provider Details

I. General information

NPI: 1346435021
Provider Name (Legal Business Name): NORTH FLORIDA CANCER INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 W NEWBERRY RD
GAINESVILLE FL
32605-4308
US

IV. Provider business mailing address

PO BOX 143067
GAINESVILLE FL
32614-3067
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5840
  • Fax: 352-333-5844
Mailing address:
  • Phone: 352-333-5840
  • Fax: 352-333-5842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERYLLE A HAYES
Title or Position: PHYSICIAN
Credential: MD
Phone: 352-333-5840