NPIMap

Organization Active NPI

Central Florida Cancer Institute PA

  • Multi-Specialty Clinic/Center
  • Lake Wales, FL
National Provider Identifier
1780923151
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
ME51222 Issued in FL
Legal business name
CENTRAL FLORIDA CANCER INSTITUTE PA
Practice address
2 State Road 60 W
Lake Wales, FL 33853-4118
Phone
(863) 679-2960
Fax
(863) 679-2781
NPI assigned
Feb 5, 2013
Last updated
Apr 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Authorized official

Name
George Martinez
Title
Cfo
Phone
(407) 566-9899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X ME51222 FL Primary

Addresses

Primary practice location

2 State Road 60 W
Lake Wales, FL 33853-4118

Mailing address

1420 Celebration Blvd
308
Celebration, FL 34747-5159
Phone (407) 566-9899

National Provider Directory

National Provider Directory

Locations

1420 Celebration Blvd
Ste 308
Kissimmee, FL 34747
Phone (407) 566-9899

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397779200000",
    "number": "1780923151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 CELEBRATION BLVD",
            "address_2": "308",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475159",
            "telephone_number": "407-566-9899",
            "fax_number": "407-566-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STATE ROAD 60 W",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534118",
            "telephone_number": "863-679-2960",
            "fax_number": "863-679-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA CANCER INSTITUTE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-05",
        "last_updated": "2014-04-18",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "407-566-9899"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "ME51222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.