LAKE CITY CANCER CARE LLC NPI 1396132213

NPI Information

NPI: 1396132213
Provider Name: LAKE CITY CANCER CARE LLC

Doing Business As: CANCER CARE OF NORTH FLORIDA & UROLOGY MEDICAL OF NORTH FLORIDA

Classification: Internal Medicine - 207RX0202X
Entity Type: Organization

Specialization: Medical Oncology

Address:
289 SW STONEGATE TER
SUITE 103
LAKE CITY, FL
ZIP 32024
Phone: (386) 755-1655
Get Directions

LAKE CITY CANCER CARE LLC is a medical oncology internal medicine in Lake City, FL. The provider is an internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. LAKE CITY CANCER CARE LLC NPI is 1396132213. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cancer Care Of North Florida & Urology Medical Of North Florida.

The provider's business location address is:

289 SW STONEGATE TER
SUITE 103
LAKE CITY, FL
ZIP 32024-456
Phone: (386) 755-1655
Fax: (386) 628-9231

The provider's authorized official is Robbie Rhymer .
The authorized official title is Cfo and has the following contact phone number (615) 467-7415.

The CLIA number assigned to this NPI record is 10D1006560 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/17/2015 and was last updated on 2/29/2024.

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	207RH0003X	Internal Medicine	Hematology & Oncology	HCC10421	FLORIDA	No
2	208800000X	Urology		HCC10606	FLORIDA	No
3	2085R0001X	Radiology	Radiation Oncology	HCC8414	FLORIDA	No
4	207RX0202X	Internal Medicine	Medical Oncology	HCC10421	FLORIDA	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	015614300	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: 4/28/2024

NPI Synchronization or Removal

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