Organization Active NPI

Florida Cancer Specialists & Research Institute, LLC

  • Hematology & Oncology Physician
  • Port Charlotte, FL
National Provider Identifier
1851409056
Registry record updated Feb 4, 2019
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
22395 Edgewater Dr
Port Charlotte, FL 33980-2012
Phone
(941) 766-7222
Fax
(941) 766-1146
NPI assigned
Aug 28, 2006
Last updated
Feb 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Authorized official

Name
Dr. Lucio Navarro Gordan, MDNPI 1346235975
Title
President/Managing Partner
Phone
(239) 274-8200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X NU
Hematology & Oncology Physician 207RH0003X NU Primary
Medical Oncology Physician 207RX0202X NU
Diagnostic Radiology Physician 2085R0202X NU
Therapeutic Radiology Physician 2085R0203X NU

Addresses

Primary practice location

22395 Edgewater Dr
Port Charlotte, FL 33980-2012

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
254016906MedicaidFL

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
10D0919186Florida Cancer Specialists & Research Institute22395 Edgewater Dr, Port Charlotte, FL 33980AccreditationSep 18, 2027

National Provider Directory

National Provider Directory

Locations

22395 Edgewater Dr
Pt Charlotte, FL 33980
Phone (941) 766-7222

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1851409056",
    "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 DEPT",
            "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": "22395 EDGEWATER DR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339802012",
            "telephone_number": "941-766-7222",
            "fax_number": "941-766-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2019-02-04",
        "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.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254016906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Cancer Specialists P L",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.