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NPI Code Detail

MEDICARE: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

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 License Number License Number State
1207RH0000XHematology (Internal Medicine) Physician
2207RX0202XMedical Oncology Physician
3207RH0003XHematology & Oncology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1174842280
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
Provider Business Mailing Address
First Line : 4371 VERONICA S SHOEMAKER BLVD
Second Line : ATTN: CREDENTIAL DEPARTMENT
City : FORT MYERS
State : FL
Zip : 33916-2216
Country : US
Telephone Number : 239-432-8339
Fax Number : 239-278-3350
Provider Business Practice Location Address
First Line : 1396 WHISPER CIR
Second Line :
City : SEBRING
State : FL
Zip : 33870-1204
Country : US
Telephone Number : 863-385-1244
Fax Number : 863-385-6086
Authorized Official
Title or Position : PRESIDENT/MANAGING PARTNER
Name : DR. LUCIO NAVARRO GORDAN
Credential :
Telephone Number : 239-274-8200
Provider Enumeration Date : 05/28/2010
Last Update Date : 06/26/2020

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