Healthcare Provider Details

I. General information

NPI: 1518220847
Provider Name (Legal Business Name): ONCOLOGY AND RADIATION ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8899 NW 18TH TER STE 203
DORAL FL
33172-2616
US

IV. Provider business mailing address

8899 NW 18TH TER STE 203
DORAL FL
33172-2616
US

V. Phone/Fax

Practice location:
  • Phone: 305-436-1036
  • Fax: 305-436-1050
Mailing address:
  • Phone: 305-436-1036
  • Fax: 305-436-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: NELLY LOPEZ
Title or Position: DIRECTOR
Credential:
Phone: 305-436-1036