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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

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 : 1295023372
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 : ATTN: CREDENTIALING DEPARTMENT
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number : 239-278-3350
Provider Business Practice Location Address
First Line : 2824 ENTERPRISE RD
Second Line :
City : ORANGE CITY
State : FL
Zip : 32763-8428
Country : US
Telephone Number : 386-774-7411
Fax Number : 386-774-7412
Authorized Official
Title or Position : PRESIDENT
Name : LUCIO NAVARRO GORDAN
Credential :
Telephone Number : 239-274-8200
Provider Enumeration Date : 07/11/2011
Last Update Date : 02/06/2023

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Directions to “FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC ” Practice Location

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