Provider Demographics
NPI:1225034457
Name:BOTERO, ANA C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:C
Last Name:BOTERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743144
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3144
Mailing Address - Country:US
Mailing Address - Phone:786-596-2000
Mailing Address - Fax:
Practice Address - Street 1:8900 N. KENDALL DRIVE
Practice Address - Street 2:MIAMI CANCER INSTITUTE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:786-596-2000
Practice Address - Fax:305-279-7778
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME931782085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16165OtherBLUE CROSS BLUE SHIELD
FL272962800Medicaid
FL16165OtherBLUE CROSS BLUE SHIELD