Healthcare Provider Details

I. General information

NPI: 1366719213
Provider Name (Legal Business Name): FLORIDA CANCER AFFILIATES PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 LITTLE RD
NEW PORT RICHEY FL
34655-1105
US

IV. Provider business mailing address

5500 LITTLE RD
NEW PORT RICHEY FL
34655-1105
US

V. Phone/Fax

Practice location:
  • Phone: 727-372-9159
  • Fax: 727-376-8703
Mailing address:
  • Phone: 727-372-9159
  • Fax: 727-376-8703

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

VIII. Authorized Official

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