Organization
FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIO NAVARRO GORDAN MD (MANAGING PARTNER)
(239) 274-8200
Entity
Organization
Contact information
Practice address
2955 BROWNWOOD BLVD, 107, THE VILLAGES, FL 32163-2040
(352) 765-7100
(352) 430-0210
Mailing address
PO BOX 102222, ATTN: CREDENTIALING DEPT, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RX0202X
Medical Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014926733
—
FL
Enumeration date
03/11/2020
Last updated
05/25/2022
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