Organization
AVENUES CANCER CARE INSTITUTE, LLC
Active
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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