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NPI Code Detail

MEDICARE: FLORIDA CANCER PHYSICIANS NETWORK LLC

MEDICARE: FLORIDA CANCER PHYSICIANS NETWORK 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
12085R0001XRadiation Oncology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3DR0495OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20014AOTHERFLBCBS

General Provider Information

NPI Number : 1770896227
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA CANCER PHYSICIANS NETWORK LLC
Provider Business Mailing Address
First Line : 2715 W VIRGINIA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33607-6327
Country : US
Telephone Number : 813-662-6024
Fax Number : 813-514-1257
Provider Business Practice Location Address
First Line : 3201 SW 33RD RD
Second Line :
City : OCALA
State : FL
Zip : 34474-7459
Country : US
Telephone Number : 352-291-2495
Fax Number : 352-291-2498
Authorized Official
Title or Position : VP INDIANA & S FLORIDA OPERATIONS
Name : NICK HERNANDEZ
Credential : MBA FACHE
Telephone Number : 813-662-6024
Provider Enumeration Date : 07/26/2010
Last Update Date : 09/21/2012

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Directions to “FLORIDA CANCER PHYSICIANS NETWORK LLC ” Practice Location

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