Healthcare Provider Details

I. General information

NPI: 1487583241
Provider Name (Legal Business Name): ACKERMAN CANCER CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 N 3RD ST
MACCLENNY FL
32063-2103
US

IV. Provider business mailing address

10881 SAN JOSE BLVD
JACKSONVILLE FL
32223-6612
US

V. Phone/Fax

Practice location:
  • Phone: 904-880-5522
  • Fax: 904-880-5533
Mailing address:
  • Phone: 904-880-5522
  • Fax: 904-880-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOT ACKERMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 904-880-5522