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NPI Code Detail

MEDICARE: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC

MEDICARE: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC
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
1281P00000XChronic Disease Hospital

General Provider Information

NPI Number : 1790122380
Entity Type Code : Organization
Provider Name (Legal Business Name) : H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC
Provider Business Mailing Address
First Line : 12902 USF MAGNOLIA DR
Second Line :
City : TAMPA
State : FL
Zip : 33612-9416
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4117 E FOWLER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33617-2011
Country : US
Telephone Number : 813-745-4746
Fax Number :
Authorized Official
Title or Position : SVP CHIEF FINANCIAL OFFICER
Name : JANENE CULUMBER
Credential :
Telephone Number : 813-745-1329
Provider Enumeration Date : 05/23/2013
Last Update Date : 05/23/2013

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