Healthcare Provider Details

I. General information

NPI: 1124226329
Provider Name (Legal Business Name): ALEJANDRO ENRIQUE CAMBARA M,D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 11/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S ANDREWS AVE
FORT LAUDERDALE FL
33316-2510
US

IV. Provider business mailing address

1700 NW 49TH ST STE 125
FORT LAUDERDALE FL
33309-3750
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-4527
  • Fax: 954-712-6688
Mailing address:
  • Phone: 954-355-4527
  • Fax: 954-712-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME 0108628
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: