NPIMap

Organization Active NPI

Moffitt Cancer Center & Research Institute

  • Special Hospital
  • Tampa, FL
National Provider Identifier
1083942064
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
PY 5272 Issued in FL
Legal business name
MOFFITT CANCER CENTER & RESEARCH INSTITUTE
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(813) 745-3862
Fax
(813) 745-3906
NPI assigned
Dec 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Authorized official

Name
Paul B. Jacobsen, PHD
Title
Chair, Health Outcomes & Behavior
Phone
(813) 745-1810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X PY 5272 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (813) 745-3862

Other identifiers 1

IdentifierTypeStateIssuer
PY5272OtherFLCLINICAL PSYCHOLOGY LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1083942064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-3862",
            "fax_number": "813-745-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-3862",
            "fax_number": "813-745-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOFFITT CANCER CENTER & RESEARCH INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CHAIR, HEALTH OUTCOMES & BEHAVIOR",
        "authorized_official_telephone_number": "813-745-1810",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "FL",
            "license": "PY 5272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGY LICENSE",
            "identifier": "PY5272",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 3, 2009; 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.