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General NPI Number Information
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NPI Number | 1942728746
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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 | 09/01/2017
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 8005 BAY ST STE 5
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City | SEBASTIAN
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State | FL
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Zip | 32958-3244
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Country | US
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Telephone | 772-581-0528
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Fax | 844-829-3327
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Provider Business Mailing Address
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Address Line | 4371 VERONICA S SHOEMAKER BLVD
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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 |
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Authorized Official
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Title or Position | PRESIDENT/MANAGING PARTNER
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Name | DR. LUCIO NAVARRO GORDAN
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Credential | MD
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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