Healthcare Provider Details

I. General information

NPI: 1235609017
Provider Name (Legal Business Name): AMERICAN ONCOLOGY PARTNERS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 COOPER RD STE 415
WESTERVILLE OH
43081-8723
US

IV. Provider business mailing address

9160 FORUM CORPORATE PKWY STE 350
FORT MYERS FL
33905-7808
US

V. Phone/Fax

Practice location:
  • Phone: 614-383-6000
  • Fax: 614-383-6223
Mailing address:
  • Phone: 239-785-3200
  • Fax:

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
# 3
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LUCIO NAVARRO GORDAN
Title or Position: PRESIDENT
Credential: MD
Phone: 239-274-8200