Healthcare Provider Details
I. General information
NPI: 1417629759
Provider Name (Legal Business Name): CANCER CENTER OF SOUTH FLORIDA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2021
Last Update Date: 06/30/2024
Certification Date: 06/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11621 KEW GARDENS AVE STE 101A
PALM BEACH GARDENS FL
33410-2853
US
IV. Provider business mailing address
PO BOX 160748
ALTAMONTE SPRINGS FL
32716-0748
US
V. Phone/Fax
- Phone: 561-253-3980
- Fax: 561-253-3985
- Phone: 561-253-3980
- Fax:
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 | 261QX0200X |
| Taxonomy | Oncology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABRAHAM
B
SCHWARZBERG
Title or Position: CEO
Credential: MD
Phone: 561-253-3980