# CENTRAL FLORIDA CANCER INSTITUTE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780923151
- **Authorized official:** GEORGE MARTINEZ (CFO)
- **Authorized official phone:** (407) 566-9899

## Contact information

- **Practice address:** 2 STATE ROAD 60 W, LAKE WALES, FL 33853-4118
- **Practice address phone:** (863) 679-2960
- **Practice address fax:** (863) 679-2781
- **Mailing address:** 1420 CELEBRATION BLVD, 308, CELEBRATION, FL 34747-5159
- **Mailing address phone:** (407) 566-9899
- **Mailing address fax:** (407) 566-9893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | ME51222 | FL | Yes |

## Other

- **Enumeration date:** 02/05/2013
- **Last updated:** 04/18/2014