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General NPI Number Information
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NPI Number | 1750694212
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Entity Type | Organization
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Legal Business Name | FLORIDA CANCER PHYSICIANS NETWORK LLC
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 3406 N LECANTO HWY SUITE A
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3548
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Country | US
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Telephone | 352-746-1100
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Fax | 352-291-2498
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Provider Business Mailing Address
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Address Line | 2715 W VIRGINIA AVE
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City | TAMPA
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State | FL
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Zip | 33607-6327
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Country | US
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Telephone | 813-662-6024
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Fax | 813-514-1257
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Authorized Official
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Title or Position | VP INDIANA & S FLORIDA OPERATIONS
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Name | NICK HERNANDEZ
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Credential | MBA FACHE
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Telephone | 813-662-6024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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