Provider Demographics
NPI:1427017326
Name:FLORIDA CANCER INSTITUTE NEW HOPE PA
Entity Type:Organization
Organization Name:FLORIDA CANCER INSTITUTE NEW HOPE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-868-9208
Mailing Address - Street 1:7324 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5518
Mailing Address - Country:US
Mailing Address - Phone:727-484-7722
Mailing Address - Fax:727-484-7781
Practice Address - Street 1:7324 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5518
Practice Address - Country:US
Practice Address - Phone:727-484-7722
Practice Address - Fax:727-484-7781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK7130OtherRAILROAD MEDICARE
FL266037700Medicaid
FL5540000005OtherPTAN
FLK4006Medicare ID - Type Unspecified