Provider Demographics
NPI:1649414582
Name:FLORIDA CANCER INSTITUTE-NEW HOPE
Entity Type:Organization
Organization Name:FLORIDA CANCER INSTITUTE-NEW HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARADONNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-596-1926
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 1:2231 HIGHWAY 44 W
Practice Address - Street 2:UNIT 203
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3879
Practice Address - Country:US
Practice Address - Phone:352-860-7400
Practice Address - Fax:352-860-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2660377-00Medicaid
FL5540000007OtherPROVIDER TRANSACTION ACCESS NUMBER (PTAN)
FL5540000007OtherPROVIDER TRANSACTION ACCESS NUMBER (PTAN)