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General NPI Number Information
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NPI Number | 1316232481
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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 | 06/16/2011
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 2848 CENTER POINTE DR UNIT A
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City | FORT MYERS
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State | FL
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Zip | 33916-9521
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Country | US
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Telephone | 239-561-9622
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Fax | 239-768-5297
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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 | 239-278-3350
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Authorized Official
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Title or Position | PRESIDENT
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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