Basic Information
| Provider Information | |||||||||
| NPI: | 1376014571 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONCOLOGY SPECIALISTS OF THE PALM BEACHES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5700 LAKE WORTH RD STE 204 | ||||||||
| Address2: | |||||||||
| City: | GREENACRES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334633213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619667707 | ||||||||
| FaxNumber: | 8883162198 | ||||||||
| Practice Location | |||||||||
| Address1: | 5401 S CONGRESS AVE STE 105 | ||||||||
| Address2: | |||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334626636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617400545 | ||||||||
| FaxNumber: | 5617400262 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2018 | ||||||||
| LastUpdateDate: | 12/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | NALLEY | ||||||||
| AuthorizedOfficialFirstName: | NANCY | ||||||||
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| AuthorizedOfficialTitleorPosition: | EHR ANALYST | ||||||||
| AuthorizedOfficialTelephone: | 5619667707 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MEDICAL SPECIALISTS OF THE PALM BEACHES INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.