NPIMap

Organization Active NPI

Precision Cancer Consultants LLC

  • Specialist
  • Tampa, FL
National Provider Identifier
1417544602
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PRECISION CANCER CONSULTANTS LLC
Practice address
14502 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2040
Phone
(813) 575-6880
Fax
(813) 969-0910
NPI assigned
Dec 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Jody Simon
Title
Manager
Phone
(813) 969-1722

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary
Genetics Clinic/Center 261QG0250X
Oncology Clinic/Center 261QX0200X

Addresses

Primary practice location

14502 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2040

Mailing address

14502 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2040
Phone (813) 575-6880

Other names 1

  • Clarified Precision Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

200 S Macdill Ave
Ste 200
Tampa, FL 33609

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1417544602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14502 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182040",
            "telephone_number": "813-575-6880",
            "fax_number": "813-969-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182040",
            "telephone_number": "813-575-6880",
            "fax_number": "813-969-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION CANCER CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-969-1722"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarified Precision Medicine",
            "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 Apr 5, 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.