Healthcare Provider Details
I. General information
NPI: 1083681837
Provider Name (Legal Business Name): ONCOLOGY HEMATOLOGY RADIATION CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2006
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8940 N KENDALL DR STE 300E
MIAMI FL
33176-2148
US
IV. Provider business mailing address
PO BOX 864381
ORLANDO FL
32886-4381
US
V. Phone/Fax
- Phone: 305-595-2141
- Fax: 305-279-7778
- Phone: 305-595-2141
- Fax: 305-279-7778
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LEONARD
KALMAN
Title or Position: CHAIRMAN
Credential: M.D.
Phone: 305-595-2141