CANCER SPECIALISTS LLC (NPI# 1689925240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689925240 |
| Entity Type | Organization |
| Organization Name | CANCER SPECIALISTS LLC |
| Other Organization Name | CANCER SPECIALISTS OF NORTH FLORIDA |
| Practice Address |
9 San Bartola Dr St Augustine FL 32086-5767 |
| Mailing Address |
7015 Ac Skinner Parkway Suite 1 Jacksonville FL 32256 |
| Practice Telephone | 9048254500 |
| Practice Fax Number | 9045283672 |
| Mailing Telephone | 9043632113 |
| Mailing Fax Number | 9045383672 |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2013-06-07 |
| Authorized Official Name | MR. ROBERT J PHELAN (CEO) |
| Authorized Official Telephone | 9043632113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | FL | Suppliers | |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 006337803 | 05 |
| Other Name | Type Code |
|---|---|
| CANCER SPECIALISTS OF NORTH FLORIDA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336607555 | Cancer Specialists LLC | Radiology | 600 Vale Park Rd N Unit A, Valparaiso, IN 46383-2546 | 2019-03-06 |
| 1376895888 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 14546 Old Saint Augustine Rd, Bldg 1 Suite 317, Jacksonville, FL 32258-5468 | 2012-10-08 |
| 1801148473 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 5742 Booth Rd, Suite A, Jacksonville, FL 32207-5982 | 2012-10-08 |
| 1215289723 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 4203 Belfort Rd, Suite 215, Jacksonville, FL 32216-1409 | 2012-10-08 |
| 1033461546 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 1375 Roberts Dr, Suite 103, Jacksonville, FL 32250-3210 | 2012-10-08 |
| 1548512056 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 1235 San Marco Blvd, Suite 202, Jacksonville, FL 32207-8554 | 2012-10-08 |
| 1306198908 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 2 Shircliff Way, Suite 800, Jacksonville, FL 32204-4753 | 2012-10-05 |
| Street Address |
9 SAN BARTOLA DR |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-5767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477558708 | Keith M Justice | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2005-06-14 |
| 1639727316 | Alysa M Gregory | Social Worker | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2019-08-27 |
| 1942745997 | Krista Lee Barber | Social Worker | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2016-12-29 |
| 1275918989 | Michelle A Hartley | Nurse Practitioner | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2015-07-23 |
| 1093129207 | Sameer M Baig | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2014-06-16 |
| 1285862185 | Hassan Ali Hassan | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2009-06-30 |
| 1043485956 | Gaurav Trikha | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2008-04-23 |
| 1922207547 | Birendra Kc | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2007-07-13 |
| 1326193764 | Integrated Community Oncology Network LLC | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2007-01-24 |
| 1861459661 | Daniele J Montgomery | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2006-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| 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 |
|---|---|---|---|---|
| 1477558708 | Keith M Justice | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2005-06-14 |
| 1548462021 | Montgomery and Associates Md | Internal Medicine | 300 Health Park Blvd, Ste 1006, St Augustine, FL 32086-3707 | 2007-06-05 |
| 1326193764 | Integrated Community Oncology Network LLC | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2007-01-24 |
| 1861459661 | Daniele J Montgomery | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2006-04-27 |
| 1952368656 | Integrated Community Oncology Network LLC | Internal Medicine | 300 Health Park Blvd, Suite 1006, St Augustine, FL 32086-3707 | 2006-04-27 |
| 1265429989 | Marc A Warmuth | Internal Medicine | 9 San Bartola Dr, St Augustine, FL 32086-5767 | 2005-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194343210 | Jayaben Patel | Internal Medicine | 11818 Shire Wycliffe Ct, Tampa, FL 33626-3329 | 2020-07-07 |
| 1922628833 | Heme Onc Call, LLC | Internal Medicine | 5825 Sw 117th St, Pinecrest, FL 33156-5007 | 2020-04-21 |
| 1457851552 | Yvette M Herrington | Internal Medicine | 425 S Parsons Ave Ste 101, Brandon, FL 33511-5290 | 2018-02-15 |
| 1104360221 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 658 Oviedo Medical Drive, Oviedo, FL 32765 | 2016-12-08 |
| 1225424369 | Florence Arnold | Internal Medicine | 3830 Bee Ridge Rd Ste 301, Sarasota, FL 34233 | 2015-04-15 |
| 1073901187 | Edward Mcaloon | Internal Medicine | 108 Homeport Dr, Palm Harbor, FL 34683-5409 | 2014-12-26 |
| 1063818235 | Barry M. Krein | Internal Medicine | 4220 Careywood Dr, Melbourne, FL 32934-7679 | 2014-11-14 |
| 1912311630 | David Longacre | Internal Medicine | 2439 Weymouth Dr, Clearwater, FL 33764-6556 | 2014-06-20 |
| 1508270778 | Gerard Chaaya | Internal Medicine | 4306 Alton Rd Fl 3, Miami Beach, FL 33140-2840 | 2014-06-16 |
| 1982026670 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 2100 W 1st St, Sanford, FL 32771-1603 | 2014-01-14 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32086 |
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| 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.