Provider Demographics
NPI:1932546314
Name:ROSS CANCER CENTER, LLC
Entity Type:Organization
Organization Name:ROSS CANCER CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-566-8727
Mailing Address - Street 1:508 GOLFPARK DR
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4626
Mailing Address - Country:US
Mailing Address - Phone:407-566-8727
Mailing Address - Fax:
Practice Address - Street 1:339 CYPRESS PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3302
Practice Address - Country:US
Practice Address - Phone:407-566-8727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty