NPIMap

Organization Active NPI

Cancer Services of Aventura LLC

  • Diagnostic Radiology Physician
  • Aventura, FL
National Provider Identifier
1790973063
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CANCER SERVICES OF AVENTURA LLC
Practice address
20950 NE 27TH CT
Aventura, FL 33180-1232
Phone
(305) 682-2151
Fax
(305) 792-5851
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joan R Gladney
Title
Regional Director
Phone
(352) 474-6190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

20950 NE 27TH CT
Aventura, FL 33180-1232

Mailing address

20950 North East 27TH Court
Aventura, FL 33180
Phone (305) 682-2151

Other identifiers 3

IdentifierTypeStateIssuer
DN4845OtherFLRR MEDICARE
00575OtherFLBCBS
279822100MedicaidFL

Other names 1

  • Aventura Comprehensive Cancer Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1790973063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20950 NORTH EAST 27TH COURT",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-682-2151",
            "fax_number": "305-792-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20950 NE 27TH CT",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801232",
            "telephone_number": "305-682-2151",
            "fax_number": "305-792-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER SERVICES OF AVENTURA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "GLADNEY",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "352-474-6190"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DN4845",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00575",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279822100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aventura Comprehensive Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.