Provider Demographics
NPI:1982608618
Name:DOCTOR'S CENTER HEMATOLOGY & ONCOLOGY GROUP, PSC
Entity Type:Organization
Organization Name:DOCTOR'S CENTER HEMATOLOGY & ONCOLOGY GROUP, PSC
Other - Org Name:DOCTOR'S CANCER CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MHMS
Authorized Official - Phone:787-621-3400
Mailing Address - Street 1:PMB #290
Mailing Address - Street 2:PO BOX 30500
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-621-3400
Mailing Address - Fax:787-621-3401
Practice Address - Street 1:CARR 2
Practice Address - Street 2:# KM47.7
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5765
Practice Address - Country:US
Practice Address - Phone:787-621-3400
Practice Address - Fax:787-621-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRS.A. 766261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084711Medicare PIN