MEDICARE: AMERICAN CANCER CONSULTANTS, P.A.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RH0003X	Hematology & Oncology Physician
2	207RX0202X	Medical Oncology Physician
3	2085R0001X	Radiation Oncology Physician

General Provider Information

NPI Number	:	1780986778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN CANCER CONSULTANTS, P.A.

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	:	11/23/2010
Last Update Date	:	11/23/2010

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