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General NPI Number Information
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NPI Number | 1790074342
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Entity Type | Organization
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Legal Business Name | FLORIDA INSTITUTE OF RESEARCH, MEDICINE, AND SURGERY, P.A.
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 1561 W. FAIRBANKS AVENUE SUITE 300
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City | WINTER PARK
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State | FL
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Zip | 32789-4678
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Country | US
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Telephone | 407-478-4200
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Fax | 407-339-8670
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Provider Business Mailing Address
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Address Line | 70 W. GORE STREET, SUITE 100 CREDENTIALING DEPARTMENT
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City | ORLANDO
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State | FL
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Zip | 32806-1124
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Country | US
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Telephone | 407-426-8484
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Fax | 407-447-5229
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Authorized Official
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Title or Position | CREDENTIALS/MNGD CARE COORDINATOR
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Name | LEE B CECIL
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Credential | CPCS
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Telephone | 407-426-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 601044
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License Number State | FL
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