Provider Demographics
NPI:1780852848
Name:UNITED ONCOLOGY MEDICAL ASSOCIATES OF FLORIDA LLC
Entity Type:Organization
Organization Name:UNITED ONCOLOGY MEDICAL ASSOCIATES OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:EAGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-323-0445
Mailing Address - Street 1:8700 SW 88TH STREET, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2212
Mailing Address - Country:US
Mailing Address - Phone:305-271-1515
Mailing Address - Fax:305-271-1115
Practice Address - Street 1:8700 SW 88TH STREET, SUITE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2212
Practice Address - Country:US
Practice Address - Phone:305-271-1515
Practice Address - Fax:305-271-1115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BR008OtherMEDICARE PTAN