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General NPI Number Information
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NPI Number | 1861427908
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE GYNECOLOGIC ONCOLOGY PA
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 21355 E DIXIE HWY SUITE 100
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City | AVENTURA
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State | FL
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Zip | 33180-1238
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Country | US
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Telephone | 305-405-0700
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Fax | 305-405-0701
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Provider Business Mailing Address
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Address Line | PO BOX 3026
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City | HALLANDALE
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State | FL
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Zip | 33008-3026
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Country | US
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Telephone | 305-405-0700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK DOMINIC CIRISANO JR.
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Credential | M.D.
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Telephone | 305-405-0700
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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 | ME 74132
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License Number State | FL
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