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NPI Code Detail

MEDICARE: CANCER DIAGNOSTIC SERVICES INC

MEDICARE: CANCER DIAGNOSTIC SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HCC5406OTHERFLAHCA

General Provider Information

NPI Number : 1063514966
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANCER DIAGNOSTIC SERVICES INC
Provider Business Mailing Address
First Line : 1451 SW 1ST ST STE 4A
Second Line :
City : MIAMI
State : FL
Zip : 33135-2202
Country : US
Telephone Number : 305-541-5067
Fax Number : 305-541-5067
Provider Business Practice Location Address
First Line : 1451 SW 1ST ST
Second Line : SUITE 4A
City : MIAMI
State : FL
Zip : 33135-2202
Country : US
Telephone Number : 305-541-5067
Fax Number : 305-541-5067
Authorized Official
Title or Position : PRESIDENT
Name : CARMEN LUIS STEEGERS
Credential :
Telephone Number : 305-541-5067
Provider Enumeration Date : 09/01/2006
Last Update Date : 08/22/2020

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Directions to “CANCER DIAGNOSTIC SERVICES INC ” Practice Location

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