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General NPI Number Information
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NPI Number | 1558581173
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Entity Type | Organization
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Legal Business Name | ONCOLOGY AND HEMATOLOGY CONSULTANTS OF PALM BEACHES
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 3385 BURNS RD STE 203
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4328
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Country | US
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Telephone | 561-691-4301
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Fax | 561-691-4517
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Provider Business Mailing Address
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Address Line | 12496 EQUINE LN
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City | WELLINGTON
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State | FL
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Zip | 33414-3508
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Country | US
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Telephone | 561-691-4301
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Fax | 561-691-4517
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUMITHRA VATTIGUNTA
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Credential | MD
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Telephone | 561-691-4301
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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 | ME92306
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License Number State | FL
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