Organization
NORTH FLORIDA CANCER CENTER TALLAHASSEE LLC
Active
Other names
Capital Regional Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN R GLADNEY (REGIONAL DIRECTOR)
(352) 474-6190
Entity
Organization
Contact information
Practice address
2003 CENTRE POINTE BLVD, TALLAHASSEE, FL 32308-4893
(850) 878-2273
(850) 671-5900
Mailing address
2003 CENTRE POINTE BLVD, TALLAHASSEE, FL 32308-4893
(850) 878-2273
(850) 671-5900
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21130
BCBS OF FL
FL
05
—
272084100
—
FL
01
—
DD1687
RR MEDICARE
FL
Enumeration date
09/30/2005
Last updated
05/01/2012
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