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General NPI Number Information
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NPI Number | 1821054701
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Entity Type | Organization
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Legal Business Name | FLORIDA HEMATOLOGY & ONCOLOGY SPECIALISTS PA
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 2501 N ORANGE AVE SUITE 201
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City | ORLANDO
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State | FL
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Zip | 32804-4603
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Country | US
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Telephone | 386-774-5211
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Fax | 386-774-5251
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Provider Business Mailing Address
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Address Line | PO BOX 741240
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City | ORANGE CITY
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State | FL
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Zip | 32774-1240
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Country | US
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Telephone | 386-774-5211
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Fax | 386-774-5251
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROY M AMBINDER
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Credential | M. D.
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Telephone | 386-774-5211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | BUS0000580-04
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | BUS0000580-004
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License Number State | FL
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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 | BUS0000580-004
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License Number State | FL
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