CENTRAL FLORIDA CANCER INSTITUTE PA (NPI# 1780923151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780923151 |
| Entity Type | Organization |
| Organization Name | CENTRAL FLORIDA CANCER INSTITUTE PA |
| Practice Address |
2 State Road 60 W Lake Wales FL 33853-4118 |
| Mailing Address |
1420 Celebration Blvd 308 Celebration FL 34747-5159 |
| Practice Telephone | 8636792960 |
| Practice Fax Number | 8636792781 |
| Mailing Telephone | 4075669899 |
| Mailing Fax Number | 4075669893 |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2014-04-18 |
| Authorized Official Name | GEORGE MARTINEZ (CFO) |
| Authorized Official Telephone | 4075669899 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
ME51222 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 263977700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235478603 | Central Florida Cancer Institute Pa | Clinic/Center | 40107 Highway 27, Davenport, FL 33837-5901 | 2013-02-05 |
| 1306870092 | Central Florida Cancer Institute Pa | Clinic/Center | 1420 Celebration Blvd, Suite 308, Celebration, FL 34747-5159 | 2006-07-10 |
| Street Address |
2 STATE ROAD 60 W |
| City | LAKE WALES |
| State | FL |
| Zip Code | 33853-4118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962854257 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 2 State Road 60 W, Lake Wales, FL 33853-4118 | 2016-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218998 | Marcel Fundora | Dentist | 701 Fl-60, Lake Wales, FL 33853 | 2020-06-04 |
| 1386291599 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 1255 Florida 60, Suite 300, Lake Wales, FL 33853 | 2019-08-22 |
| 1932753472 | Adeline Brooke Warren | Occupational Therapist | 512 S 11th Street, Lake Wales, FL 33853 | 2019-08-01 |
| 1033563580 | Amber Y Shepard | Family Medicine | 1255 Highway 60 E Ste 500, Lake Wales, FL 33853 | 2016-04-21 |
| 1174982458 | Ledesha Marie Dorothy Maduro | Dentist | 24185 Us Hwy 27 North, Lake Wales, FL 33853 | 2016-02-16 |
| 1528402435 | Buck Andreu Scott | Surgery | 407 S 11th St, Lake Wales, FL 33853 | 2013-04-22 |
| 1447598321 | Central Florida Health Care, Inc. | Dentist | 305 West Central Avenue, Lake Wales, FL 33853 | 2013-01-28 |
| 1972864932 | Kevin T Barlow, Pa. Dba: Winter Haven Audiology and Ridge Audiology. | Clinic/Center | 704 Sr 60 East, Lake Wales, FL 33853 | 2012-06-06 |
| 1316266364 | Elba M Lopez | Massage Therapist | 318 S. First Street, Lake Wales, FL 33853 | 2010-05-28 |
| 1063657955 | Lake Wales Medical Imaging Center One, Inc | Technician, Health Information | 1255 Highway 60 East 110, Lake Wales, FL 33853 | 2008-12-08 |
| Find all providers in zip 33853 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | LAKE WALES |
| Zip Code | 33853 |
Please comment or provide details below to improve the information on CENTRAL FLORIDA CANCER INSTITUTE PA.
| 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.