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General NPI Number Information
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NPI Number | 1639287709
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Entity Type | Organization
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Legal Business Name | AMERICAN CANCER TREATMENT CENTER
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 211 CORAL SANDS DR
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2749
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Country | US
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Telephone | 321-632-3400
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Fax | 321-632-1766
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Provider Business Mailing Address
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Address Line | 211 CORAL SANDS DR
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2749
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Country | US
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Telephone | 321-632-3400
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Fax | 321-632-1766
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Authorized Official
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Title or Position | OWNER
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Name | WASFI A MAKAR
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Credential | MD
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Telephone | 321-632-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number |
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License Number State |
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