| NPI | 1023485679 |
|---|---|
| Doing Business As | SAND LAKE CANCER CENTER DISPENSARY |
| Entity Type | Organization |
| Authorized Contact | ASHA N JIAWAN Practice Administrator 407-351-1002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME73340) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2015-08-31 |