Provider Demographics
NPI:1720462773
Name:METCARE ONCOLOGY
Entity type:Organization
Organization Name:METCARE ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-805-8530
Mailing Address - Street 1:6101 BLUE LAGOON DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2055
Mailing Address - Country:US
Mailing Address - Phone:305-500-2114
Mailing Address - Fax:305-370-6024
Practice Address - Street 1:1200 W GRANADA BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8156
Practice Address - Country:US
Practice Address - Phone:386-615-1056
Practice Address - Fax:386-615-1033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROPOLITAN HEALTH NETWORKS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-18
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPTANOtherCX415B