FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC (NPI# 1063815421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063815421 |
| Entity Type | Organization |
| Organization Name | FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC |
| Other Organization Name | FLORIDA CANCER SPECIALISTS P L |
| Practice Address |
224 Memorial Medical Pkwy Suite 300 Daytona Beach FL 32117-5122 |
| Mailing Address |
4371 Veronica S Shoemaker Blvd Attn: Credentialing Fort Myers FL 33916-2216 |
| Practice Telephone | 3862314060 |
| Practice Fax Number | 8136306199 |
| Mailing Telephone | 2392748200 |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2019-02-04 |
| Authorized Official Name | LUCIO NAVARRO GORDAN (PRESIDENT / MANAGING PARTNER) |
| Authorized Official Telephone | 2392748200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0000X |
Internal Medicine Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 2540169-96 | 05 |
| Other Name | Type Code |
|---|---|
| Florida Cancer Specialists P L | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051482 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 5130 Linton Blvd Ste B4, Delray Beach, FL 33484-6595 | 2020-10-21 |
| 1124649710 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 1658 St Vincents Way Ste 340, Middleburg, FL 32068-8431 | 2020-05-05 |
| 1063054153 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 5985 Silver Falls Run, Suite 200, Bradenton, FL 34211-1291 | 2019-10-10 |
| 1750857397 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 900 Pine St Ste 111, Englewood, FL 34223-4457 | 2018-10-22 |
| 1598290694 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 2257 Us Highway 441 N, Suite C, Okeechobee, FL 34972-1943 | 2017-04-26 |
| 1437528080 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 1301 2nd Ave Sw Ste 290, Largo, FL 33770-3120 | 2015-09-24 |
| 1972912632 | Florida Cancer Specialists & Research Institute, LLC | Clinical Medical Laboratory | 2848 Center Pointe Dr Ste B, Fort Myers, FL 33916-9521 | 2014-08-07 |
| 1528402393 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 7463 State Road 52, Hudson, FL 34667-6714 | 2013-04-24 |
| 1265775209 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 4801 S Congress Ave Ste 400, Lake Worth, FL 33461-4746 | 2013-03-28 |
| 1629328745 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 810 N Spring Garden Ave, Suite 100, Deland, FL 32720-3106 | 2012-09-17 |
| Street Address |
224 MEMORIAL MEDICAL PKWY SUITE 300 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285690529 | Karin P Bigman | Internal Medicine | 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 | 2006-04-25 |
| 1962854281 | Jennifer Robinson | Dietitian, Registered | 224 Memorial Medical Pkwy, Daytona Beach, FL 32117-5111 | 2016-07-11 |
| 1598119943 | Cindy Trawick | Nurse Practitioner | 224 Memorial Medical Pkwy, Daytona Beach, FL 32117-5111 | 2016-04-21 |
| 1902068158 | Eric Michael Harris | Internal Medicine | 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 | 2008-06-30 |
| 1821290362 | Mudussara Asad Khan | Internal Medicine | 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 | 2007-06-05 |
| 1457300014 | Florida Oncology Network Pa | Radiology | 224 Memorial Medical Pkwy, Daytona Beach, FL 32117-5122 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952350548 | Murthy V Andavolu | Internal Medicine | 303 N Clyde Morris Blvd Fl 2, Daytona Beach, FL 32114-2709 | 2006-05-09 |
| 1285690529 | Karin P Bigman | Internal Medicine | 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 | 2006-04-25 |
| 1861627663 | Zafar Latif | Internal Medicine | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2009-05-21 |
| 1902068158 | Eric Michael Harris | Internal Medicine | 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 | 2008-06-30 |
| 1821290362 | Mudussara Asad Khan | Internal Medicine | 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 | 2007-06-05 |
| 1184726184 | Walter James Durkin | Internal Medicine | 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 | 2006-09-01 |
| 1013019918 | Richard Carl Weiss | Internal Medicine | 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 | 2006-09-01 |
| 1134221070 | Boon Yee Chew | Internal Medicine | 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 | 2006-09-01 |
| 1336241413 | Abdul Sorathia | Internal Medicine | 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 | 2006-09-01 |
| 1780786848 | Gregory Favis | Internal Medicine | 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 | 2006-09-01 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.