Provider Demographics
NPI:1265581466
Name:FLORIDA CANCER SPECIALISTS P L
Entity type:Organization
Organization Name:FLORIDA CANCER SPECIALISTS P L
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:HARWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-274-8200
Mailing Address - Street 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3224
Practice Address - Street 1:117 W BAY ST
Practice Address - Street 2:
Practice Address - City:WAUCHULA
Practice Address - State:FL
Practice Address - Zip Code:33873-3135
Practice Address - Country:US
Practice Address - Phone:863-773-4700
Practice Address - Fax:863-773-2916
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA CANCER SPECIALISTS PL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83334207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CN6270Medicare PIN
FL21682EMedicare PIN