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CANCER SPECIALISTS LLC NPI 1801148473


NPI Information

NPI: 1801148473
Provider Name: CANCER SPECIALISTS LLC

Doing Business As: CANCER SPECIALISTS OF NORTH FLORIDA

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 10D0269280

Address:
5742 BOOTH RD
SUITE A
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 739-7779
Get Directions

CANCER SPECIALISTS LLC is a hematology and oncology internal medicine in Jacksonville, 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. CANCER SPECIALISTS LLC NPI is 1801148473. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cancer Specialists Of North Florida.

The provider's business location address is:

5742 BOOTH RD
SUITE A
JACKSONVILLE, FL
ZIP 32207-982
Phone: (904) 739-7779
Fax: (904) 739-7771

The provider's authorized official is Robert J Phelan .
The authorized official title is Credentialing and has the following contact phone number (904) 363-2113.

The CLIA number assigned to this NPI record is 10D0269280 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/8/2012 and was last updated on 7/6/2021.


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
1207RH0003XInternal MedicineHematology & OncologyFLORIDAYes
2332B00000XDurable Medical Equipment & Medical SuppliesFLORIDANo

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
1006337801MEDICAIDFLORIDA

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: 11/14/2023

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