CANCER CENTER OF MELBOURNE LLC (NPI# 1366875387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366875387 |
| Entity Type | Organization |
| Organization Name | CANCER CENTER OF MELBOURNE LLC |
| Practice Address |
415 S. Wickham Rd. Melbourne FL 32904 |
| Practice Telephone | 3218212282 |
| Practice Fax Number | 3218210666 |
| Mailing Telephone | 3218212282 |
| Mailing Fax Number | 3218210666 |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |
| Authorized Official Name | DR. WASFI A MAKAR (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3219601587 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
ME56764 | FL | Ambulatory Health Care Facilities |
| Street Address |
415 S. WICKHAM RD. |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| 1861647109 | Genesis Rehabilitation Services | Nursing Care | 7260-2 Greenboro Dr, West Melbourne, FL 32904 | 2008-12-01 |
| Find all providers in zip 32904 | ||||
| Taxonomy Code | 261QX0203X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology, Radiation |
| Definition to come... |
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| 1285784389 | Mid-florida Radiation Oncology Pa | Clinic/Center | 1780 Se Hillmoor Dr, Port St Lucie, FL 34952-7558 | 2007-01-11 |
| 1720159247 | Pedro A Serrano-ojeda | Clinic/Center | 3125 Nw 84th Ave, Doral, FL 33122-1994 | 2006-11-13 |
| 1740201912 | North Florida Radiation Oncology LLC | Clinic/Center | 6420 Newberry Road, Gainesville, FL 32605 | 2006-07-22 |
| 1609896083 | Mid-florida Radiation Oncology Pa | Clinic/Center | 301 Ne 19th Dr, Okeechobee, FL 34972-1911 | 2006-07-20 |
| 1700860681 | Epirad Inc. | Clinic/Center | 400 Se Osceola St, Ste. 2, Stuart, FL 34994-2504 | 2005-12-03 |
| 1144211988 | Mid Florida Radiation Oncology Asso | Clinic/Center | 604 W Midway Rd, Fort Pierce, FL 34982-4201 | 2005-11-01 |
| 1659834174 | Sarasota Memorial Hospital | Clinic/Center | 5370 University Pkwy, Sarasota, FL 34243-5800 | 2019-04-11 |
| 1073019352 | Proton International - Delray, LLC | Clinic/Center | 5280 Linton Blvd, Delray Beach, FL 33484-6516 | 2018-04-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.