Healthcare Provider Details

I. General information

NPI: 1871541037
Provider Name (Legal Business Name): BRRH ONCOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NORTHWEST 13TH STREET 2ND FLOOR
BOCA RATON FL
33486
US

IV. Provider business mailing address

PO BOX 71200
CHARLOTTE NC
28272-1200
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-6400
  • Fax: 561-955-2730
Mailing address:
  • Phone: 561-495-8307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LINCOLN MENDEZ
Title or Position: CEO
Credential:
Phone: 561-955-3032