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NPI Code Detail

MEDICARE: VIRGINIA CANCER INSTITUTE INCORPORATED

MEDICARE: VIRGINIA CANCER INSTITUTE INCORPORATED
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
12085R0202XDiagnostic Radiology Physician
2261QM1300XMulti-Specialty Clinic/Center
3291U00000XClinical Medical Laboratory
4207RH0003XHematology & Oncology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CM1776OTHERVARR MEDICARE

General Provider Information

NPI Number : 1730130980
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIRGINIA CANCER INSTITUTE INCORPORATED
Provider Business Mailing Address
First Line : 7202 GLEN FOREST DR
Second Line : SUITE 200
City : RICHMOND
State : VA
Zip : 23226-3781
Country : US
Telephone Number : 804-391-4171
Fax Number : 804-200-6229
Provider Business Practice Location Address
First Line : 8007 DISCOVERY DR STE A
Second Line :
City : RICHMOND
State : VA
Zip : 23229-8605
Country : US
Telephone Number : 804-287-3000
Fax Number : 804-673-2731
Authorized Official
Title or Position : MANAGING PARTNER
Name : PABLO M GONZALEZ
Credential : M.D.
Telephone Number : 804-391-4171
Provider Enumeration Date : 05/12/2006
Last Update Date : 02/16/2024

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Directions to “VIRGINIA CANCER INSTITUTE INCORPORATED ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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