Healthcare Provider Details

I. General information

NPI: 1225821663
Provider Name (Legal Business Name): ONCOLOGY AND RADIATION ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 W 20TH AVE STE 214
HIALEAH FL
33016-5531
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 305-826-8606
  • Fax: 305-364-0166
Mailing address:
  • Phone:
  • 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

VIII. Authorized Official

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