Organization
CANCER SERVICES OF AVENTURA LLC
Active
Organization
CANCER SERVICES OF AVENTURA LLC
Active
Other names
Aventura Comprehensive Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN R GLADNEY (REGIONAL DIRECTOR)
(352) 474-6190
Entity
Organization
Contact information
Practice address
20950 NE 27TH CT, AVENTURA, FL 33180-1232
(305) 682-2151
(305) 792-5851
Mailing address
20950 NORTH EAST 27TH COURT, AVENTURA, FL 33180
(305) 682-2151
(305) 792-5851
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00575
BCBS
FL
05
—
279822100
—
FL
01
—
DN4845
RR MEDICARE
FL
Enumeration date
10/11/2007
Last updated
05/02/2012
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