Healthcare Provider Details

I. General information

NPI: 1184990871
Provider Name (Legal Business Name): RUPESH RAJESH KOTECHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N. KENDALL DR MIAMI CANCER INSTITUTE
MIAMI FL
33176-2118
US

IV. Provider business mailing address

PO BOX 743144
ATLANTA GA
30374-3144
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-2000
  • Fax: 305-279-8887
Mailing address:
  • Phone: 786-596-2000
  • Fax: 305-279-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME131122
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: