Healthcare Provider Details

I. General information

NPI: 1780653618
Provider Name (Legal Business Name): H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/26/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12902 MAGNOLIA DR
TAMPA FL
33612-9416
US

IV. Provider business mailing address

12902 MAGNOLIA DR
TAMPA FL
33612-9416
US

V. Phone/Fax

Practice location:
  • Phone: 813-745-4673
  • Fax:
Mailing address:
  • Phone: 813-745-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number4334
License Number StateFL

VIII. Authorized Official

Name: MR. SARABDEEP SINGH
Title or Position: EXECUTIVE VP COO
Credential:
Phone: 813-745-7222