NORTH FLORIDA CANCER CENTER LAKE CITY LLC NPI 1902893902

NPI Information

NPI: 1902893902
Provider Name: NORTH FLORIDA CANCER CENTER LAKE CITY LLC

Doing Business As: THE CANCER CENTER AT LAKE CITY

Classification: Radiology - 2085R0001X
Entity Type: Organization

Specialization: Radiation Oncology

Address:
795 SW HIGHWAY 47
LAKE CITY, FL
ZIP 32025
Phone: (386) 758-7822
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NORTH FLORIDA CANCER CENTER LAKE CITY LLC is a radiation oncology radiology in Lake City, FL. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. NORTH FLORIDA CANCER CENTER LAKE CITY LLC NPI is 1902893902. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As The Cancer Center At Lake City.

The provider's business location address is:

795 SW HIGHWAY 47
LAKE CITY, FL
ZIP 32025
Phone: (386) 758-7822
Fax: (386) 758-2224

The provider's authorized official is Joan R Gladney .
The authorized official title is Regional Director and has the following contact phone number (352) 474-6190.

The enumeration date for this NPI number is 10/4/2005 and was last updated on 5/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0001X	Radiology	Radiation Oncology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	74629	OTHER	FLORIDA	BCBS
2	K7593	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA
3	DD1689	OTHER	FLORIDA	RR MEDICARE
4	272085000	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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