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General NPI Number Information
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NPI Number | 1295406726
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Entity Type | Organization
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Legal Business Name | SOUTH MIAMI GYN ONCOLOGY PHYSICIANS LLC
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 15955 SW 96TH ST STE 400
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City | MIAMI
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State | FL
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Zip | 33196-1273
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Country | US
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Telephone | 786-596-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 742057
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City | ATLANTA
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State | GA
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Zip | 30374-2057
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MATTHEW ARSENAULT
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Credential |
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Telephone | 786-662-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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