Provider Demographics
NPI:1063514966
Name:CANCER DIAGNOSTIC SERVICES INC
Entity type:Organization
Organization Name:CANCER DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:STEEGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-541-5067
Mailing Address - Street 1:1451 SW 1ST ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2202
Mailing Address - Country:US
Mailing Address - Phone:305-541-5067
Mailing Address - Fax:305-541-5067
Practice Address - Street 1:1451 SW 1ST ST
Practice Address - Street 2:SUITE 4A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2202
Practice Address - Country:US
Practice Address - Phone:305-541-5067
Practice Address - Fax:305-541-5067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC5406OtherAHCA
FLE1808Medicare ID - Type Unspecified