Provider Demographics
NPI:1649766247
Name:AMERICAN ONCOLOGY PARTNERS, P.A.
Entity Type:Organization
Organization Name:AMERICAN ONCOLOGY PARTNERS, P.A.
Other - Org Name:GENESIS CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIO
Authorized Official - Middle Name:N
Authorized Official - Last Name:GORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-266-0555
Mailing Address - Street 1:9160 FORUM CORPORATE PKWY STE 350
Mailing Address - Street 2:ATTENTION: CREDENTIALING
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-7808
Mailing Address - Country:US
Mailing Address - Phone:866-266-0555
Mailing Address - Fax:866-266-4999
Practice Address - Street 1:136 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953
Practice Address - Country:US
Practice Address - Phone:501-624-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty