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Organization
LAKE CITY CANCER CARE LLC
Active
Organization
LAKE CITY CANCER CARE LLC
Active
Other names
Cancer Care of North Florida & Urology Medical of North Florida
Organization subpart
No
Provider details
NPI number
Authorized official
CHAOQIANG LIN (EXECUTIVE VICE PRESIDENT & CFO)
(214) 587-4079
Entity
Organization
Contact information
Practice address
289 SW STONEGATE TER, SUITE 103, LAKE CITY, FL 32024-3456
(386) 755-1655
(386) 628-9231
Mailing address
289 SW STONEGATE TER STE 103, LAKE CITY, FL 32024-3457
(386) 755-1655
(386) 628-9231
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
HCC10421
FL
207RX0202X
Medical Oncology Physician
HCC10421
FL
2085R0001X
Radiation Oncology Physician
HCC8414
FL
208800000X
Urology Physician
HCC10606
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015614300
—
FL
Enumeration date
04/17/2015
Last updated
05/20/2026
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