MEDICARE: SOUTH FLORIDA PHYSICIAN SPECIALISTS LLC

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
1	2085R0001X	Radiation Oncology Physician		FL

General Provider Information

NPI Number	:	1548508682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA PHYSICIAN SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	3599 UNIVERSITY BLVD S
Second Line	:	SUITE 805
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4252
Country	:	US
Telephone Number	:	904-309-8680
Fax Number	:	904-345-5841

Provider Business Practice Location Address
First Line	:	7867 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-7742
Country	:	US
Telephone Number	:	904-309-8680
Fax Number	:	904-345-5841

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MITCHELL D TERK
Credential	:	MD
Telephone Number	:	904-309-8680

Provider Enumeration Date	:	01/24/2013
Last Update Date	:	03/05/2013

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