Healthcare Provider Details

I. General information

NPI: 1467522748
Provider Name (Legal Business Name): CANCER CARE & CHEMOTHERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 HWY 441N SUITE #J
OKEECHOBEE FL
34972-1900
US

IV. Provider business mailing address

1900 NEBRASKA AVE SUITE #2
FT. PIERCE FL
34950-4837
US

V. Phone/Fax

Practice location:
  • Phone: 863-467-9000
  • Fax: 863-467-9229
Mailing address:
  • Phone: 772-489-4000
  • Fax: 772-489-4066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: VASEEM SYED AKHTAR
Title or Position: PRESIDENT
Credential: MD
Phone: 863-467-9000