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General NPI Number Information
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NPI Number | 1760997571
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Entity Type | Organization
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Legal Business Name | BROWARD ONCOLOGY AND SICKLE CELL CENTER
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Dates
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Enumeration Date | 12/04/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1330 SE 4TH AVE STE J
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-1958
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Country | US
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Telephone | 954-623-7299
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Fax | 954-525-3033
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Provider Business Mailing Address
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Address Line | 5324 SW 34TH WAY
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City | FT LAUDERDALE
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State | FL
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Zip | 33312-5545
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Country | US
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Telephone | 954-623-7299
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Fax | 954-525-3033
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | ARCHANA MAINI
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Credential | M.D.
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Telephone | 954-623-7299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME97695
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License Number State | FL
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