Provider Demographics
NPI:1275890105
Name:MSMC ONCOLOGY, LLC
Entity Type:Organization
Organization Name:MSMC ONCOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINACE
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUTKAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-674-2662
Mailing Address - Street 1:4300 ALTON ROAD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2800
Mailing Address - Country:US
Mailing Address - Phone:305-674-2841
Mailing Address - Fax:305-535-7919
Practice Address - Street 1:4300 ALTON ROAD
Practice Address - Street 2:2ND FLOOR ASCHER BUILDING
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-674-2841
Practice Address - Fax:305-535-7919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty