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	2085R0203X	Therapeutic Radiology Physician
2	291U00000X	Clinical Medical Laboratory
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician
4	2085R0001X	Radiation Oncology Physician
5	2085R0202X	Diagnostic Radiology Physician
6	207RH0000X	Hematology (Internal Medicine) Physician
7	207ZC0006X	Clinical Pathology Physician
8	207ZH0000X	Hematology (Pathology) Physician
9	207RX0202X	Medical 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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
29	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
33	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
34	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
35	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
36	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
37	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760590962
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	:	239-278-3350

Provider Business Practice Location Address
First Line	:	1708 CAPE CORAL PKWY W
Second Line	:	#10
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-6985
Country	:	US
Telephone Number	:	239-541-4633
Fax Number	:	239-541-1825

Authorized Official
Title or Position	:	PRESIDENT/MANAGING PARTNER
Name	:	DR. LUCIO N. GORDAN
Credential	:	M.D.
Telephone Number	:	352-332-3900

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	11/12/2024

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