Healthcare Provider Details
I. General information
NPI: 1245739069
Provider Name (Legal Business Name): ONCOLOGY NETWORK SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2018
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8323 NW 12TH ST STE 115
DORAL FL
33126-1839
US
IV. Provider business mailing address
8323 NW 12TH ST STE 115
DORAL FL
33126-1839
US
V. Phone/Fax
- Phone: 305-284-7484
- Fax:
- Phone: 305-284-7484
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSE
A
PELAYO
Title or Position: CEO
Credential:
Phone: 305-284-7484