Provider Demographics
NPI:1467522748
Name:CANCER CARE & CHEMOTHERAPY CENTER
Entity Type:Organization
Organization Name:CANCER CARE & CHEMOTHERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VASEEM
Authorized Official - Middle Name:SYED
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-467-9000
Mailing Address - Street 1:1900 NEBRASKA AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:FT. PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4837
Mailing Address - Country:US
Mailing Address - Phone:772-489-4000
Mailing Address - Fax:772-489-4066
Practice Address - Street 1:1713 HWY 441N
Practice Address - Street 2:SUITE #J
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1900
Practice Address - Country:US
Practice Address - Phone:863-467-9000
Practice Address - Fax:863-467-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379169600Medicaid
K6238AMedicare ID - Type Unspecified
G05362Medicare UPIN