Basic Information
| Provider Information | |||||||||
| NPI: | 1003440835 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN ONCOLOGY PARTNERS, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9160 FORUM CORPORATE PKWY STE 350 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339057808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2397853200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 ASHVILLE AVE STE 310 | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275188682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192338585 | ||||||||
| FaxNumber: | 9192338566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2020 | ||||||||
| LastUpdateDate: | 03/02/2020 | ||||||||
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| AuthorizedOfficialLastName: | GORDAN | ||||||||
| AuthorizedOfficialFirstName: | LUCIO | ||||||||
| AuthorizedOfficialMiddleName: | NAVARRO | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2392748200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 261QX0200X | N | Ambulatory Health Care Facilities | Clinic/Center | Oncology | 207RH0003X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.