Healthcare Provider Details

I. General information

NPI: 1295032001
Provider Name (Legal Business Name): NORTH COUNTY CANCER INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8645 NORTH MILITARY TRAIL SUITE 408
PALM BEACH GARDENS FL
33410-6294
US

IV. Provider business mailing address

8645 NORTH MILITARY TRAIL SUITE 408
PALM BEACH GARDENS FL
33410-6294
US

V. Phone/Fax

Practice location:
  • Phone: 855-867-6224
  • Fax:
Mailing address:
  • Phone: 855-867-6224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. JUAN ERNESTO SANCHEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-371-0094