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General NPI Number Information
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NPI Number | 1467251454
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Entity Type | Organization
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Legal Business Name | BARDMOOR CANCER CENTER LLC
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 3155 N MCMULLEN BOOTH RD
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City | CLEARWATER
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State | FL
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Zip | 33761-2008
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Country | US
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Telephone | 727-320-0200
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Fax | 727-394-8934
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Provider Business Mailing Address
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Address Line | 104 WOODMONT BLVD STE 500
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City | NASHVILLE
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State | TN
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Zip | 37205-2245
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Country | US
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Telephone | 615-467-7400
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MARTIN C HARLAN
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Credential |
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Telephone | 615-252-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology 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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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