Healthcare Provider Details

I. General information

NPI: 1255369955
Provider Name (Legal Business Name): MID-FLORIDA CANCER CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2776 ENTERPRISE ROAD SUITE 100
ORANGE CITY FL
32763-8316
US

IV. Provider business mailing address

2776 ENTERPRISE RD STE 100
ORANGE CITY FL
32763-8316
US

V. Phone/Fax

Practice location:
  • Phone: 386-774-1223
  • Fax: 386-774-4658
Mailing address:
  • Phone: 386-774-1223
  • Fax: 386-774-4658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: JOEY SACCO I
Title or Position: CEO
Credential:
Phone: 407-461-8324