Healthcare Provider Details

I. General information

NPI: 1285953158
Provider Name (Legal Business Name): PHILIP PANCARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 N ORANGE AVE STE 601
ORLANDO FL
32804-5558
US

IV. Provider business mailing address

2415 N ORANGE AVE STE 601
ORLANDO FL
32804-5558
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2070
  • Fax:
Mailing address:
  • Phone: 407-303-2070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD448504
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MA10501800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME161180
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: