MEDICARE: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RH0000X	Hematology (Internal Medicine) Physician
2	207RX0202X	Medical Oncology Physician
3	207RH0003X	Hematology & Oncology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063815421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 102222
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-2222
Country	:	US
Telephone Number	:	239-274-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 MEMORIAL MEDICAL PKWY
Second Line	:	SUITE 300
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5122
Country	:	US
Telephone Number	:	386-231-4060
Fax Number	:	813-630-6199

Authorized Official
Title or Position	:	PRESIDENT / MANAGING PARTNER
Name	:	LUCIO NAVARRO GORDAN
Credential	:
Telephone Number	:	239-274-8200

Provider Enumeration Date	:	09/30/2014
Last Update Date	:	11/15/2024

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