Organization
AVENUES CANCER CARE INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS A. OTEYZA M.D. (MEDICAL DIRECTOR)
(904) 551-3122
Entity
Organization
Contact information
Practice address
6144 GAZEBO PARK PL S, SUITE 211, JACKSONVILLE, FL 32257-1099
(904) 651-9895
Mailing address
PO BOX 57946, JACKSONVILLE, FL 32241-7946
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME0043663
FL
Other
Enumeration date
04/13/2011
Last updated
03/26/2012
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