Organization
CENTRAL FLORIDA CANCER INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY HEYSEK (CFO)
(407) 566-9899
Entity
Organization
Contact information
Practice address
40107 HIGHWAY 27, DAVENPORT, FL 33837-5901
(863) 419-0692
(863) 419-1695
Mailing address
1420 CELEBRATION BLVD, CELEBRATION, FL 34747-5159
(407) 566-9899
(407) 566-9899
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
ME51222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263977700
—
FL
Enumeration date
02/05/2013
Last updated
12/23/2022
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