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General NPI Number Information
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NPI Number | 1336568583
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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 | 04/15/2014
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 1630 SE 18TH ST BLDG 600, SUITE 602
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City | OCALA
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State | FL
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Zip | 34471-5471
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Country | US
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Telephone | 352-369-0181
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Fax | 352-369-0246
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Provider Business Mailing Address
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Address Line | 4371 VERONICA S SHOEMAKER BLVD ATTN: CREDENTIALING
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City | FORT MYERS
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State | FL
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Zip | 33916-2216
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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 | 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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