Provider Demographics
NPI:1639287709
Name:AMERICAN CANCER TREATMENT CENTER
Entity Type:Organization
Organization Name:AMERICAN CANCER TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WASFI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-632-3400
Mailing Address - Street 1:211 CORAL SANDS DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2749
Mailing Address - Country:US
Mailing Address - Phone:321-632-3400
Mailing Address - Fax:321-632-1766
Practice Address - Street 1:211 CORAL SANDS DR
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2749
Practice Address - Country:US
Practice Address - Phone:321-632-3400
Practice Address - Fax:321-632-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation