MEDICARE: HEMATOLOGY AND MEDICAL ONCOLOGY OF SOUTHERN PALM BEACH COUNTY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician		FL

General Provider Information

NPI Number	:	1437157062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMATOLOGY AND MEDICAL ONCOLOGY OF SOUTHERN PALM BEACH COUNTY INC

Provider Business Mailing Address
First Line	:	2623 S SEACREST BLVD
Second Line	:	SUITE 216
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7501
Country	:	US
Telephone Number	:	561-742-0065
Fax Number	:	561-742-0105

Provider Business Practice Location Address
First Line	:	2623 S SEACREST BLVD
Second Line	:	SUITE 216
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7501
Country	:	US
Telephone Number	:	561-742-0065
Fax Number	:	561-742-0105

Authorized Official
Title or Position	:	OWNER
Name	:	ROGILIO A BRITO
Credential	:	D.O.
Telephone Number	:	561-742-0065

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/21/2022

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