Palm Coast Oncology

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

ME88511 Issued in FL

Legal business name

PALM COAST ONCOLOGY

Practice address

61 Memorial Medical Pkwy
Suite 3808
Palm Coast, FL 32164-5981

Phone

(386) 586-2889

Fax

(386) 586-2890

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

Philip Ndep Ndum, M.D

Title

President of Corporation

Phone

(386) 586-2889

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1861689424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 3808",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-586-2889",
            "fax_number": "386-586-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 3808",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-586-2889",
            "fax_number": "386-586-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM COAST ONCOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "NDUM",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "NDEP",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "386-586-2889",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME88511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "ME88511",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palm Coast Dental, LLC
• Palm Coast Health Care Associates LLC
• Palm Coast Health Care Services, LLC
• Palm Coast Internal Medicine PA
• Palm Coast Mobile Physical Therapy Services
• Palm Coast Optical Co. Inc.
• Palm Coast Pkwy Opco LLC
• Palm Coast Recovery Center LLC
• Palm Coast Sports Medicine and Rehab
• Palm Coast Surgery Center LLC

• Hematology & Oncology Physician in Palm Coast, FL
• Providers in Palm Coast, 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 Apr 20, 2008; 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.