Provider Demographics
NPI:1730142373
Name:THE ONCOLOGY INSTITUTE FL, LLC
Entity Type:Organization
Organization Name:THE ONCOLOGY INSTITUTE FL, LLC
Other - Org Name:THE ONCOLOGY INSTITUTE OF HOPE AND INNOVATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:VIRNICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-699-3970
Mailing Address - Street 1:18000 STUDEBAKER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2671
Mailing Address - Country:US
Mailing Address - Phone:562-735-3226
Mailing Address - Fax:727-347-9348
Practice Address - Street 1:6499 38TH AVE N
Practice Address - Street 2:SUITE G1
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1656
Practice Address - Country:US
Practice Address - Phone:727-381-3761
Practice Address - Fax:727-347-9348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051314207RH0003X
207RH0003X, 207RX0202X, 261QX0203X, 332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, RadiationGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1730142373Medicaid
FL5170460001OtherDME PROVIDER NUMBER
FL5170460001Medicare NSC
FLK7142Medicare PIN