NPIMap

Organization Active NPI

Florida Cancer Specialists & Research Institute, LLC

  • Hematology & Oncology Physician
  • Tampa, FL
National Provider Identifier
1104071349
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
Practice address
3402 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6214
Phone
(813) 875-3950
Fax
(813) 876-0432
NPI assigned
Dec 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Authorized official

Name
Lucio Navarro Gordan
Title
President/Managing Partner
Phone
(239) 274-8200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0000X
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X

Addresses

Primary practice location

3402 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6214

Mailing address

4371 Veronica S Shoemaker Blvd
Attn: Credential Dept
Fort Myers, FL 33916-2216
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
254016928MedicaidFL

Other names 1

  • Florida Cancer Specialists P L Former legal business name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0290189Florida Cancer Specialists & Research Institute3402 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607AccreditationSep 3, 2027

National Provider Directory

National Provider Directory

Locations

3402 W Mlk Blvd
Tampa, FL 33607
Phone (813) 875-3950

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1104071349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "address_2": "ATTN: CREDENTIAL DEPT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076214",
            "telephone_number": "813-875-3950",
            "fax_number": "813-876-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "GORDAN",
        "authorized_official_first_name": "LUCIO",
        "authorized_official_middle_name": "NAVARRO",
        "authorized_official_title_or_position": "PRESIDENT/MANAGING PARTNER",
        "authorized_official_telephone_number": "239-274-8200"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254016928",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Cancer Specialists P L",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.