Healthcare Provider Details

I. General information

NPI: 1710122734
Provider Name (Legal Business Name): FLORIDA CANCER SPECIALISTS P L
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4902 N ARMENIA AVE
TAMPA FL
33603-1402
US

IV. Provider business mailing address

4371 VERONICA S SHOEMAKER BLVD ATTN: CREDENTIAL DEPT
FORT MYERS FL
33916-2216
US

V. Phone/Fax

Practice location:
  • Phone: 813-876-0035
  • Fax: 813-876-2363
Mailing address:
  • Phone: 239-274-8200
  • Fax: 239-278-3224

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 Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM N HARWIN
Title or Position: PRESIDENT/MANAGING PARTNER
Credential: M.D.
Phone: 239-274-8200