MEDICARE: SOUTH FLORIDA CANCER INSTITUTE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RX0202X	Medical Oncology Physician
2	208600000X	Surgery Physician
3	363L00000X	Nurse Practitioner
4	2086X0206X	Surgical Oncology Physician

General Provider Information

NPI Number	:	1790287878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA CANCER INSTITUTE

Provider Business Mailing Address
First Line	:	1005 MARINA MILE BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-2433
Country	:	US
Telephone Number	:	954-658-6439
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 MARINA MILE BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-2433
Country	:	US
Telephone Number	:	954-658-6439
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ALIA ABDULLA
Credential	:	DO
Telephone Number	:	954-465-4693

Provider Enumeration Date	:	03/05/2018
Last Update Date	:	03/25/2020

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Directions to “SOUTH FLORIDA CANCER INSTITUTE ” Practice Location

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