Organization Active NPI

Florida Cancer Specialists & Research Institute, LLC

  • Hematology & Oncology Physician
  • North Port, FL
National Provider Identifier
1235462052
Registry record updated Oct 8, 2021
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
1390 Grand Venture Dr
North Port, FL 34286-2309
Phone
(941) 257-2280
Fax
(941) 423-9180
NPI assigned
Sep 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Authorized official

Name
Dr. 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 FL Primary
Medical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RX0202X FL

Addresses

Primary practice location

1390 Grand Venture Dr
North Port, FL 34286-2309

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
254016931MedicaidFL

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
10D1091152Florida Cancer Specialists & Research Institute,1390 Grand Venture Dr, North Port, FL 34286AccreditationNov 3, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1235462052",
    "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 DEPARTMENT",
            "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": "1390 GRAND VENTURE DR",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862309",
            "telephone_number": "941-257-2280",
            "fax_number": "941-423-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-11",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "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",
        "authorized_official_name_prefix": "Dr."
    },
    "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": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254016931",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Cancer Specialists P L",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.