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General NPI Number Information
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NPI Number | 1790287878
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA CANCER INSTITUTE
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 03/25/2020
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Provider Practice Location Address
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Address Line | 1005 MARINA MILE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2433
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Country | US
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Telephone | 954-658-6439
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 MARINA MILE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2433
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Country | US
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Telephone | 954-658-6439
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ALIA ABDULLA
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Credential | DO
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Telephone | 954-465-4693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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