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H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC NPI 1306833595


NPI Information

NPI: 1306833595
Provider Name: H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC

Doing Business As: MOFFITT MEDICAL GROUP

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 10D2283811

Address:
12902 USF MAGNOLIA DR
TAMPA, FL
ZIP 33612
Phone: (813) 745-4673
Get Directions

H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC is a hematology and oncology internal medicine in Tampa, FL. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC NPI is 1306833595. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Moffitt Medical Group.

The provider's business location address is:

12902 USF MAGNOLIA DR
TAMPA, FL
ZIP 33612-416
Phone: (813) 745-4673

The provider's authorized official is Martha Blanton .
The authorized official title is Credentialing Coordinator and has the following contact phone number (813) 745-4673.

The CLIA number assigned to this NPI record is 10D2283811 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/3/2005 and was last updated on 2/2/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyNo
2207SG0201XMedical GeneticsClinical Genetics (M.D.)No
3207VX0201XObstetrics & GynecologyGynecologic OncologyNo
42083P0901XPreventive MedicinePublic Health & General Preventive MedicineNo
52085R0202XRadiologyDiagnostic RadiologyNo
62086X0206XSurgerySurgical OncologyNo
7207RH0003XInternal MedicineHematology & OncologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
124755OTHERFLORIDABCBS
210D0965510OTHERFLORIDACLIA
33400057OTHERFLORIDAUNITED HEALTHCARE
4=========OTHERFLORIDATRICARE
5373056500MEDICAIDFLORIDA
639785MEDICARE PINFLORIDA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.