SAND LAKE CANCER CENTER PA NPI 1609278597

NPI Information

NPI: 1609278597
Provider Name: SAND LAKE CANCER CENTER, PA

Doing Business As: SAND LAKE CANCER CENTER DISPENSARY

Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
7301 STONEROCK CIR STE 2
ORLANDO, FL
ZIP 32819
Phone: (407) 351-1002
Get Directions

SAND LAKE CANCER CENTER, PA is a medical physician assistant in Orlando, FL. SAND LAKE CANCER CENTER, PA NPI is 1609278597. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sand Lake Cancer Center Dispensary.

The provider's business location address is:

7301 STONEROCK CIR STE 2
ORLANDO, FL
ZIP 32819-004
Phone: (407) 351-1002
Fax: (407) 351-1119

The provider's authorized official is Asha Jiawan .
The authorized official title is Practice Administrator and has the following contact phone number (407) 351-1002.

The enumeration date for this NPI number is 9/23/2014 and was last updated on 11/11/2022.

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	174400000X	Specialist		ME73340	FLORIDA	No
2	174400000X	Specialist		ME76724	FLORIDA	No
3	174400000X	Specialist		ME116521	FLORIDA	No
4	363AM0700X	Physician Assistant	Medical	PA9106328	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	K9074	OTHER	FLORIDA	PTAN

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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