1861781577 NPI number — ONCOLOGY HEMATOLOGY RADIATION CARE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861781577 NPI number — ONCOLOGY HEMATOLOGY RADIATION CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCOLOGY HEMATOLOGY RADIATION CARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861781577
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9350 SUNSET DR
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33173-3286
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-594-4210
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6200 SUNSET DR
Provider Second Line Business Practice Location Address:
STE 601
Provider Business Practice Location Address City Name:
SOUTH MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33143-4828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-595-2141
Provider Business Practice Location Address Fax Number:
786-268-6329
Provider Enumeration Date:
04/04/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KALMAN
Authorized Official First Name:
LEONARD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
786-594-4210

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 272911324 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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