Provider Demographics
NPI:1134260573
Name:SURGICAL ONCOLOGY ASSOCIATES OF SOUTH FLORIDA INC
Entity type:Organization
Organization Name:SURGICAL ONCOLOGY ASSOCIATES OF SOUTH FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:DONOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-986-6366
Mailing Address - Street 1:4000 HOLLYWOOD BLVD
Mailing Address - Street 2:PRESIDENTIAL CIRCLE, SUITE 160 NORTH
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6751
Mailing Address - Country:US
Mailing Address - Phone:954-986-6366
Mailing Address - Fax:
Practice Address - Street 1:4000 HOLLYWOOD BLVD
Practice Address - Street 2:PRESIDENTIAL CIRCLE, SUITE 160 NORTH
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6751
Practice Address - Country:US
Practice Address - Phone:954-986-6366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38248OtherBLUE CROSS BLUE SHIELD
FL38248Medicare PIN