Hello BB62... I'm very sorry to hear about your husband's diagnosis. It's a devastating blow to hear those words, and unfortunately, most of us here have heard them. You are doing the right thing by searching for options and the best care possible. We are not doctors here, so cannot really answer your question about going straight to bladder removal. That is a question for a bc specialist who sees many cases per year.
I was diagnosed locally in Bristol,then referred to Vanderbilt due to having one of those tumors in the "rare" category. I had a partial cystectomy performed at Vanderbilt in Feb. 2010, and I still go back there for my followup care. So far I am cancer free after six years.
I don't know anything about Moffit, but I am very pleased with the care I received by the Vanderbilt doctors and staff. Dr. Chang, Dr. Smith, Dr. Barocas, and Dr. Clark specialize in Urologic Oncology. My surgeon left Vanderbilt in 2012 (est.) to accept the Head of Urology at Oklahoma University, his hometown. I now see Dr. Clark. His nurse said he does a lot of surgical procedures at the nearby VA Hospital, as well as at Vanderbilt. I would be confident in any of them. Here is a link to their website where you can look at ratings and some patient comments.
Vanderbilt Urology
I wish you the best in your pursuit to find the right doctor who is the best fit for your husband.