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General NPI Number Information
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NPI Number | 1083617211
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Entity Type | Individual
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Provider Name | MARIA DEL ROSARIO CICCIA MD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 3501 JOHNSON ST FL 1
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5421
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Country | US
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Telephone | 954-265-8000
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Fax | 954-276-0471
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Provider Business Mailing Address
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Address Line | 2900 CORPORATE WAY DOOR D
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City | MIRAMAR
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State | FL
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Zip | 33025-3925
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Country | US
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Telephone | 954-276-5685
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Fax | 954-985-7074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME72617
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License Number State | FL
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