MOFFITT MEDICAL GROUP
NPI 1306833595
Internal Medicine - Hematology & Oncology in Tampa, FL

Q: What is H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Active since October 03, 2005

12902 USF MAGNOLIA DR, TAMPA, FL 33612(813) 745-4673 Get Directions Write a Review

NPPES record last updated: December 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 26, 2024, Sep 9, 2024 (2 updates tracked since 2024).

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About Moffitt Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOFFITT MEDICAL GROUP (NPI 1306833595) is a healthcare organization registered as a hematology & oncology in Tampa, Florida and active in the NPI registry since October 2005. The organization maintains 5 additional practice locations and lists Maureen Clement, Director, as its authorized official.

NPPES Registry Identity

NPI1306833595

Entity TypeOrganization

Primary Taxonomy207RH0003X

Legal Business NameH LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC

Location Address12902 USF MAGNOLIA DRTampa, FL 33612-9416

Mailing AddressPo Box 198441Atlanta, GA 30384-8441 · (866) 761-5658

Phone(813) 745-4673

Organization SubpartNo

Authorized OfficialMaureen ClementDirector · (813) 745-4673

Enumeration DateOctober 3, 2005

Last NPPES UpdateDecember 26, 20242 updates tracked since enumeration

NPPES CertifiedDecember 26, 2024

✔ NPI 1306833595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Also ListedDermatologyTaxonomy 207N00000X

Also ListedMedical Genetics · Clinical Genetics (M.D.)Taxonomy 207SG0201X

Also ListedObstetrics & Gynecology · Gynecologic OncologyTaxonomy 207VX0201X

Also ListedPreventive Medicine · Public Health & General Preventive MedicineTaxonomy 2083P0901X

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X

Also ListedSurgery · Surgical OncologyTaxonomy 2086X0206X

12902 USF MAGNOLIA DR, Tampa, FL 33612

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Other Names 1

Doing Business AsMoffitt Medical Group

Secondary Practice Locations 5

Location 12590 Healing Way Ste 200Wesley Chapel, FL 33543-5497 · Phone (813) 745-4673

Location 22590 Healing Way Ste 100Wesley Chapel, FL 33543-5496 · Phone (813) 745-4673

Location 310920 McKinley DrTampa, FL 33612-6471 · Phone (813) 745-4673

Location 410901 McKinley DrTampa, FL 33612-6455 · Phone (813) 745-4673

Location 54101 Jim Walter BlvdTampa, FL 33607-5775 · Phone (813) 745-4673

Other Identifiers 4

Medicaid373056500FL

Other24755FL · Bcbs

Other3400057FL · United Healthcare

Other10D0965510FL · Clia

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL MARTIN WACH MD

Surgery