Organization
SAND LAKE CANCER CENTER
Active
Parent organization
SAND LAKE CANCER CENTER PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAND LAKE CANCER CENTER PA
Authorized official
MRS. ASHA JIAWAN (FINANCE DIRECTOR)
(407) 351-1002
Entity
Organization
Contact information
Practice address
7301 STONEROCK CIRCLE, ORLANDO, FL 32819
(407) 351-1002
(407) 351-1096
Mailing address
7301 STONEROCK CIR, SUITE 2, ORLANDO, FL 32819-8002
(407) 351-1002
(407) 351-1119
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
BH4500460
FL
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255280900
—
FL
Enumeration date
07/04/2006
Last updated
07/21/2022
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