National Provider Identifier Database

NORTH FLORIDA CANCER CENTER LAKE CITY LLC
Radiation Oncology

A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.


Contact Information

NORTH FLORIDA CANCER CENTER LAKE CITY LLC
795 SW HIGHWAY 47
LAKE CITY, FL32025
Phone: 386-758-7822
Fax: 386-758-2224
Website:
Specialty Taxonomy Code
* Radiation Oncology 2085R0001X

* Indicates primary specialty

NPI Profile & details for NORTH FLORIDA CANCER CENTER LAKE CITY LLC

NPI Number 1902893902
Legal business name
LBN
NORTH FLORIDA CANCER CENTER LAKE CITY LLC
Authorized official JOAN GLADNEY - (REGIONAL DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 10/04/2005
Last updated 05/01/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • FL Medicaid: 272085000
  • FL Other: 74629 BCBS
  • FL Other: DD1689 RR MEDICARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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