TREASURE COAST CANCER CARE CENTER INC
Osteopathic Medicine at Hillmoor Dr, Fort Pierce, FL

License number
Florida ME0070221
Category
Osteopathic Medicine
Type
Medical Oncology
Owner
Name: DR. SIVA P BELLAM M.D
Title: PRESIDENT
Phone: (772) 398-6016
Address
Address
1700 SE Hillmoor Dr STE 306, Fort Pierce, FL 34952
National Provider ID: 1407841810
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TREASURE COAST CANCER CARE CENTER, INC

Fort Pierce, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Treasure Coast Cancer Care Center
Inactive reason:
Amendment
Registration:
Jan 26, 1999
Inactive since:
Jan 24, 2014
Phone:
(772) 398-6016 (Phone), (772) 335-3200 (Alt)
Addresses:
1700 SE Hilmoore Dr SUITE 306, Port Saint Lucie, FL 34952 (Physical)
1700 SE Hillmoor Dr #306, Port Saint Lucie, FL 34952
State ID:
P99000007349
Business type:
Florida Profit Corporation
S:
Sivaprasad Bellam (President, Treasurer, Director, Secretary), 1700 SE Hilmoore Dr, Port Saint Lucie, FL 34952 (Physical),Sai Vijaya Bellam, 1700 SE Hillmoor Dr, Port Saint Lucie, FL 34952 (Physical),Janakiram Ravipati (Secretary), 1700 SE Hillmoor Dr, Port Saint Lucie, FL 34952 (Physical),...
Agent:
Siva Bellam,1700 SE Hillmoor Dr, Port Saint Lucie, FL 34952 (Physical)
EIN:
65-0891840
Categories:
Physicians & Surgeons - Family Practice, Physicians & Surgeons

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