NPIMap

Organization Active NPI

Sand Lake Cancer Center

  • Infusion Therapy Clinic/Center
  • Orlando, FL
National Provider Identifier
1821028804
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
SAND LAKE CANCER CENTER
Practice address
7301 Stonerock Circle
Orlando, FL 32819
Phone
(407) 351-1002
Fax
(407) 351-1096
NPI assigned
Jul 4, 2006
Organization subpart
Yes
Parent organization
SAND LAKE CANCER CENTER PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Asha Jiawan
Title
Finance Director
Phone
(407) 351-1002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 1835X0200X BH4500460 FL
Infusion Therapy Clinic/Center 261QI0500X FL Primary

Addresses

Primary practice location

7301 Stonerock Circle
Orlando, FL 32819

Mailing address

7301 Stonerock Cir
Suite 2
Orlando, FL 32819-8002
Phone (407) 351-1002

Other identifiers 1

IdentifierTypeStateIssuer
255280900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051229000245 FL Part B Supplier - Clinic/Group Practice 2062434475 Receives reassigned benefits from 13 practitioners
Practice locations: Kissimmee, FL; Orlando, FL; Saint Cloud, FL

National Provider Directory

National Provider Directory
Part of
Sand Lake Cancer Center PA

Locations

9430 Turkey Lake Rd
Ste 208
Orlando, FL 32819
Phone (407) 345-0065

7301 Stonerock Cir
Ste 2
Orlando, FL 32819
Phone (407) 351-1002

3002 17th St
Saint Cloud, FL 34769
Phone (407) 351-1002

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1821028804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 STONEROCK CIR",
            "address_2": "SUITE 2",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198002",
            "telephone_number": "407-351-1002",
            "fax_number": "407-351-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 STONEROCK CIRCLE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32819",
            "telephone_number": "407-351-1002",
            "fax_number": "407-351-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAND LAKE CANCER CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAND LAKE CANCER CENTER PA",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-07-21",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "JIAWAN",
        "authorized_official_first_name": "ASHA",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "407-351-1002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1835X0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Oncology",
            "state": "FL",
            "license": "BH4500460",
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255280900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.