Provider Demographics
NPI:1083010839
Name:H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE
Entity Type:Organization
Organization Name:H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENETIC COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:813-745-4810
Mailing Address - Street 1:4117 E FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2011
Mailing Address - Country:US
Mailing Address - Phone:813-745-4810
Mailing Address - Fax:813-745-5445
Practice Address - Street 1:4117 E FOWLER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-2011
Practice Address - Country:US
Practice Address - Phone:813-745-4810
Practice Address - Fax:813-745-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital