Organization
CANCER CARE OF NORTH FLORIDA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WASEEM KHAN M.D. (PRESIDENT)
(386) 755-1655
Entity
Organization
Contact information
Practice address
289 SW STONEGATE TER, SUITE 103, LAKE CITY, FL 32024-3457
(386) 755-1655
(386) 755-2330
Mailing address
PO BOX 1642, LAKE CITY, FL 32056-1642
(386) 755-1655
(386) 755-2330
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276120300
—
FL
01
—
39239
BCBS
FL
01
—
DE8930
RR MCR
FL
Enumeration date
06/14/2006
Last updated
12/30/2024
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