Provider Demographics
NPI:1598826406
Name:MIAMI PEDIATRIC HEMATOLOGY ONCOLOGY ASSOCIATES
Entity type:Organization
Organization Name:MIAMI PEDIATRIC HEMATOLOGY ONCOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IVY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-663-8551
Mailing Address - Street 1:3100 SW 62ND AVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3009
Mailing Address - Country:US
Mailing Address - Phone:305-662-8360
Mailing Address - Fax:305-666-6387
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-662-8360
Practice Address - Fax:305-666-6387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL92539YMedicare ID - Type Unspecified
FL95475YMedicare ID - Type Unspecified
FLC68795Medicare UPIN
FL23317ZMedicare ID - Type Unspecified
FLF66087Medicare UPIN
FL12693ZMedicare ID - Type Unspecified
FLD27875Medicare UPIN
FLD27638Medicare UPIN