Organization
MC RADIATION ONCOLOGY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA SMITH (AUTHORIZED OFFICIAL)
(773) 954-6579
Entity
Organization
Contact information
Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(305) 714-0094
Mailing address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(305) 714-0094
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME103176
MEDICAL LICENSE
FL
Enumeration date
10/29/2018
Last updated
10/29/2018
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