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Organization

CLERMONT CANCER CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICKI MCKNIGHT CHC (COMPLIANCE DIRECTOR)
(949) 385-5012
Entity
Organization

Contact information

Practice address
1361 CITRUS TOWER BLVD, SUITE 100, CLERMONT, FL 34711-1924
(352) 242-1366
Mailing address
2865 E COAST HWY, SUITE 200, CORONA DEL MAR, CA 92625-2236
(949) 207-3300

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary

Other

Enumeration date
07/01/2015
Last updated
07/01/2015
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