| Central Florida Cancer Institute Pa | |
|
40107 Highway 27 Davenport FL 33837-5901 | |
| (863) 419-0692 | |
| (863) 419-1695 |
| Full Name | Central Florida Cancer Institute Pa |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 40107 Highway 27, Davenport, Florida |
| Authorized Official Name and Position | Randy Heysek (CFO) |
| Authorized Official Contact | 4075669899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Florida Cancer Institute Pa 1420 Celebration Blvd Celebration FL 34747-5159 Ph: (407) 566-9899 | Central Florida Cancer Institute Pa 40107 Highway 27 Davenport FL 33837-5901 Ph: (863) 419-0692 |
| NPI Number | 1235478603 |
|---|---|
| Provider Enumeration Date | 02/05/2013 |
| Last Update Date | 12/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235478603 | NPI | - | NPPES |
| 263977700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | ME51222 (Florida) | Primary |
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