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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 Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

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

NPI # 1902893902
LBN Legal business name NORTH FLORIDA CANCER CENTER LAKE CITY LLC
Authorized official JOAN GLADNEY - (REGIONAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/04/2005
Last updated 05/01/2012 - About 14 years ago
Identifiers
FL Medicaid 272085000
FL Other 74629 BCBS
FL Other DD1689 RR MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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