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General NPI Number Information
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NPI Number | 1336331602
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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 | 08/10/2007
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 5985 SILVER FALLS RUN STE 200
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City | BRADENTON
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State | FL
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Zip | 34211-1291
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Country | US
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Telephone | 941-907-4737
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Fax | 941-907-9493
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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
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Name | 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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME94215
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License Number State | FL
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Taxonomy #3
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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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