Provider Demographics
NPI:1598075632
Name:SOUTH FLORIDA WOMENS CANCER CARE LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA WOMENS CANCER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RECIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-997-8991
Mailing Address - Street 1:401 LINTON BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-8193
Mailing Address - Country:US
Mailing Address - Phone:561-447-0090
Mailing Address - Fax:
Practice Address - Street 1:401 LINTON BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-8193
Practice Address - Country:US
Practice Address - Phone:561-447-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty