MEDICARE: AMERICAN CANCER TREATMENT CENTER

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	261QX0203X	Radiation Oncology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639287709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN CANCER TREATMENT CENTER

Provider Business Mailing Address
First Line	:	211 CORAL SANDS DR
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-2749
Country	:	US
Telephone Number	:	321-632-3400
Fax Number	:	321-632-1766

Provider Business Practice Location Address
First Line	:	211 CORAL SANDS DR
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-2749
Country	:	US
Telephone Number	:	321-632-3400
Fax Number	:	321-632-1766

Authorized Official
Title or Position	:	OWNER
Name	:	WASFI A MAKAR
Credential	:	MD
Telephone Number	:	321-632-3400

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	06/13/2008

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