Provider Demographics
NPI:1821446972
Name:INSTITUTO DE CANCER DEL OESTE LLC
Entity Type:Organization
Organization Name:INSTITUTO DE CANCER DEL OESTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:REMEDIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-813-4401
Mailing Address - Street 1:CARR 349 KM 2.7
Mailing Address - Street 2:BELLA VISTA CANCER INSTITUTE
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-1750
Mailing Address - Country:US
Mailing Address - Phone:787-813-4401
Mailing Address - Fax:787-813-4403
Practice Address - Street 1:CARR 349 KM 2.7
Practice Address - Street 2:BELLA VISTA CANCER INSTITUTE
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1750
Practice Address - Country:US
Practice Address - Phone:787-813-4401
Practice Address - Fax:787-813-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty