NPIMap

Organization Active NPI

H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc.

  • Specialty Pharmacy
  • Tampa, FL
National Provider Identifier
1023756475
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.
Practice address
12902 Usf Magnolia Drive
Mailstop: MCC-Pharm
Tampa, FL 33612
Phone
(813) 745-7354
Fax
(813) 745-1484
NPI assigned
May 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sophia Mariela Alfonso, PHARMD
Title
Pharmacy Manager
Phone
(813) 745-6085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X Primary

Addresses

Primary practice location

12902 Usf Magnolia Drive
Mailstop: MCC-Pharm
Tampa, FL 33612

Mailing address

12902 Usf Magnolia Drive
Mailstop: MCC-Pharm
Tampa, FL 33612
Phone (813) 745-7354

Other identifiers 1

IdentifierTypeStateIssuer
109430100MedicaidFL

Other names 1

  • Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
H Lee Moffitt Cancer CT5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1023756475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DRIVE",
            "address_2": "MAILSTOP: MCC-PHARM",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-745-7354",
            "fax_number": "813-745-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DRIVE",
            "address_2": "MAILSTOP: MCC-PHARM",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-745-7354",
            "fax_number": "813-745-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "ALFONSO",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_middle_name": "MARIELA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "813-745-6085",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109430100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.