# CANCER CENTER OF MELBOURNE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366875387
- **Authorized official:** DR. WASFI A MAKAR M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (321) 960-1587

## Contact information

- **Practice address:** 415 S. WICKHAM RD., MELBOURNE, FL 32904
- **Practice address phone:** (321) 821-2282
- **Practice address fax:** (321) 821-0666
- **Mailing address:** 415 S. WICKHAM RD., MELBOURNE, FL 32904
- **Mailing address phone:** (321) 821-2282
- **Mailing address fax:** (321) 821-0666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0203X | Radiation Oncology Clinic/Center | ME56764 | FL | Yes |

## Other

- **Enumeration date:** 08/13/2013
- **Last updated:** 08/13/2013