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Organization

FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROXANE CHERYL WILTSHIRE (CREDENTIALING MANAGER)
(239) 224-3159
Entity
Organization

Contact information

Practice address
1658 ST VINCENTS WAY STE 340, MIDDLEBURG, FL 32068-8431
(904) 269-6526
(904) 269-6527
Mailing address
4371 VERONICA S SHOEMAKER BLVD, FORT MYERS, FL 33916-2216
(239) 274-8200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207RH0000X
Hematology (Internal Medicine) Physician
207RX0202X
Medical Oncology Physician
Primary

Other

Enumeration date
05/05/2020
Last updated
05/05/2020
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