Provider Demographics
NPI:1518365725
Name:BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC
Entity Type:Organization
Organization Name:BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-662-7111
Mailing Address - Street 1:9350 SW 72ND ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3286
Mailing Address - Country:US
Mailing Address - Phone:786-594-4210
Mailing Address - Fax:786-594-4299
Practice Address - Street 1:6200 SUNSET DR
Practice Address - Street 2:SUITE 601
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4828
Practice Address - Country:US
Practice Address - Phone:305-595-2141
Practice Address - Fax:786-268-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies