1558774224 NPI number — UF CANCER CENTER AT ORLANDO HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558774224 NPI number — UF CANCER CENTER AT ORLANDO HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UF CANCER CENTER AT ORLANDO HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558774224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 S ORANGE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32806-2134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-841-1869
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1414 KUHL AVE
Provider Second Line Business Practice Location Address:
MP 710
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32806-2008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-841-6947
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2014

Additional Information

Authorized Official

Authorized Official Last Name:
WOJTECZKO
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE OPERATIONS MANAGER
Authorized Official Telephone Number:
321-841-1869

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PAT9107947 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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