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General NPI Number Information
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NPI Number | 1053750661
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Entity Type | Organization
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Legal Business Name | R GASTESI, MD PA
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 2780 N FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1424
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Country | US
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Telephone | 954-564-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 2780 N FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1424
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Country | US
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Telephone | 954-564-1111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROMAN GASTESI
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Credential | MD
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Telephone | 954-298-1273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | ME0017960
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License Number State | FL
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