H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC

Doing business as

Moffitt Medical Group

Practice address

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Phone

(813) 745-4673

NPI assigned

Oct 3, 2005

Last updated

Dec 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maureen Clement

Title

Director

Phone

(813) 745-4673

Specialties & licenses 7

Addresses

Other identifiers 4

Other names 1

• MOFFITT MEDICAL GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in FL, TX, AZ, NC, HI5 enrollments

Enrollment records 5

Locations

Interoperability endpoints

• Direct secure messaging: aarti.patel@direct.moffitt.org
• Direct secure messaging: adam.cohen@direct.moffitt.org
• Direct secure messaging: adam.kornicki@direct.moffitt.org
• Direct secure messaging: adam.winkler@direct.moffitt.org
• Direct secure messaging: adetomiwa.shokunbi@direct.moffitt.org
• Direct secure messaging: ahmad.arslan@direct.moffitt.org
• Direct secure messaging: ahmed.abdelrahman@direct.moffitt.org
• Direct secure messaging: alan.chu@direct.moffitt.org
• Direct secure messaging: alberto.chiappori@direct.moffitt.org
• Direct secure messaging: alec.chau@direct.moffitt.org
• Direct secure messaging: alejandra.riveron@direct.moffitt.org
• Direct secure messaging: alexander.lazarides@direct.moffitt.org
• Direct secure messaging: alexandra.pisklakova@direct.moffitt.org
• Direct secure messaging: alison.burt@direct.moffitt.org
• Direct secure messaging: alison.walker@direct.moffitt.org
• Direct secure messaging: aliyah.baluch@direct.moffitt.org
• Direct secure messaging: allan.escher@direct.moffitt.org
• Direct secure messaging: allan.limapereira@direct.moffitt.org
• Direct secure messaging: amad.choudhry@direct.moffitt.org
• Direct secure messaging: amalia.stefanou@direct.moffitt.org

Practitioners 1,346

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Enas Abdallah, MD

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1083134555
  Medicare reassignment Care Compare group NPD
• Edith Abraham, ARNP

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1134735285
  Medicare reassignment Care Compare group NPD
• Amal Hani Abukhdeir, NP-C

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1609423946
  Medicare reassignment Care Compare group NPD
• Ashraf Abulhaija, APRN

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1114176526
  Medicare reassignment Care Compare group NPD
• Marjorie Lynn Acierno, ARNP

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1194910885
  Medicare reassignment Care Compare group NPD
• Robert Samuel Ackerman, M.D.

  • Interventional Pain Medicine Physician
  • Tampa, FL
  • NPI 1598290868
  Medicare reassignment Care Compare group NPD
• Lauren Ann Adams, APRN-BC

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1013790922
  Medicare reassignment Care Compare group NPD
• Sonia Roxanne Adamson, APRN

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1871042507
  Medicare reassignment Care Compare group NPD
• Gunjan Aeron, M.D.

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1871721894
  Medicare reassignment Care Compare group NPD
• Thanh-Phuong Afiat, MD

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1811359037
  Medicare reassignment Care Compare group NPD
• Sarimar Agosto Salgado, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Tampa, FL
  • NPI 1588951560
  Medicare reassignment Care Compare group NPD
• Samantha Lea Bell Aguinaga, APRN

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1649638123
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1306833595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "866-761-5658"
        },
        {
            "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": "813-745-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2590 Healing Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335435497",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2590 Healing Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335435496",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10920 McKinley Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336126471",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10901 McKinley Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336126455",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4101 Jim Walter Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336075775",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10901 McKinley Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336126455",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "CLEMENT",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "813-745-4673"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "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": "207SG0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373056500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "24755",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3400057",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D0965510",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOFFITT MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• GYN Network, LLC
• Kailyn Gyorkos
• Gloria Gysbertsen, ARNP
• H & H Perficient LLC
• H & S Rehabilitation Center Inc
• H Lee Moffitt Cancer Ctr and Research Inst LCSC Inc
• H-Ez Behavior Inc
• H. Lee Moffitt Cancer Center & Research Institute
• H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc
• H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. (Clinic Pharmacy)

• Hematology & Oncology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.