Healthcare Provider Details

I. General information

NPI: 1235835216
Provider Name (Legal Business Name): LAKE CITY CANCER CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4520 W US HIGHWAY 90
LAKE CITY FL
32055-8341
US

IV. Provider business mailing address

104 WOODMONT BLVD STE 500
NASHVILLE TN
37205-2245
US

V. Phone/Fax

Practice location:
  • Phone: 352-755-0601
  • Fax: 352-755-0602
Mailing address:
  • Phone: 615-783-1071
  • Fax: 615-783-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT RHYMER
Title or Position: EVP HR & CHIEF CLINICAL OPERATIONS
Credential:
Phone: 615-467-7415