Provider Demographics
NPI:1831116276
Name:E PLUS FLORIDA COMPREHENSIVE CANCER CARE, LLC
Entity Type:Organization
Organization Name:E PLUS FLORIDA COMPREHENSIVE CANCER CARE, LLC
Other - Org Name:COMMUNITY CANCER CENTER OF NORTH FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CCOO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-7415
Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:500
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-467-7400
Mailing Address - Fax:615-467-7401
Practice Address - Street 1:7000 NW 11TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3144
Practice Address - Country:US
Practice Address - Phone:352-331-0900
Practice Address - Fax:352-331-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2011-12-13
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
FL270266500Medicaid
FL270266500Medicaid