Healthcare Provider Details

I. General information

NPI: 1366433211
Provider Name (Legal Business Name): VINAY R SAXENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 45TH ST STE 204
MANGONIA PARK FL
33407-2450
US

IV. Provider business mailing address

5955 PONCE DE LEON BLVD
CORAL GABLES FL
33146
US

V. Phone/Fax

Practice location:
  • Phone: 561-558-1212
  • Fax: 561-558-1292
Mailing address:
  • Phone: 305-661-1515
  • Fax: 305-663-5948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME87714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: