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General NPI Number Information
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NPI Number | 1245675875
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Entity Type | Organization
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Legal Business Name | FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1 MEMORIAL MEDICAL PKWY STE 200
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City | PALM COAST
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State | FL
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Zip | 32164-5979
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Country | US
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Telephone | 386-586-2889
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Fax | 386-586-2890
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Provider Business Mailing Address
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Address Line | PO BOX 102222
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City | ATLANTA
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State | GA
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Zip | 30368-2222
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Country | US
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Telephone | 239-274-8200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / MANAGING PARTNER
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Name | DR. LUCIO NAVARRO GORDAN
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Credential |
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Telephone | 239-274-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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