Healthcare Provider Details
I. General information
NPI: 1871922476
Provider Name (Legal Business Name): FLORIDA CANCER SPECIALISTS P L
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3238 COVE BEND DR
TAMPA FL
33613-2752
US
IV. Provider business mailing address
4371 VERONICA S SHOEMAKER BLVD
FORT MYERS FL
33916-2216
US
V. Phone/Fax
- Phone: 813-632-7547
- Fax: 813-632-7549
- Phone: 239-274-8200
- Fax: 239-278-3350
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
N
HARWIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 239-274-8200