Organization Name: | LAKEWOOD RANCH ONCOLOGY CENTER |
NPI Number: | 1043458151 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM G. JACKSON (OPERATIONS MANAGER) |
Mailing Address: | 8946 77th Ter E Lakewood Ranch |
State: | FL US |
Postal Code: | 342026421 |
Phone Number: | 9419079053 |
Fax Number: | 9419079473 |
NPI Enumeration Date: | 01/27/2009 |
NPI Last Update Date: | 01/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QX0203X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Oncology, Radiation |
Taxonomy Definition: |