MEDICARE: FLORIDA CANCER SPECIALISTS P L

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
1	207RH0003X	Hematology & Oncology Physician	ME35430	FL

General Provider Information

NPI Number	:	1972669711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA CANCER SPECIALISTS P L

Provider Business Mailing Address
First Line	:	4371 VERONICA S SHOEMAKER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-2216
Country	:	US
Telephone Number	:	239-274-8200
Fax Number	:	239-278-3224

Provider Business Practice Location Address
First Line	:	4371 VERONICA S SHOEMAKER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-2216
Country	:	US
Telephone Number	:	239-274-8200
Fax Number	:	239-278-3224

Authorized Official
Title or Position	:	PRESIDENT MANAGING PARTNER
Name	:	WILLIAM HARWIN
Credential	:	M.D.
Telephone Number	:	239-274-8200

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	09/28/2007

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