Basic Information
| Provider Information | |||||||||
| NPI: | 1497167381 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONTRERAS | ||||||||
| FirstName: | JESSIKA | ||||||||
| MiddleName: | ANNY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4921 PARKVIEW PLACE | ||||||||
| Address2: | LL | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631101032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3147477236 | ||||||||
| FaxNumber: | 3147479557 | ||||||||
| Practice Location | |||||||||
| Address1: | 8900 N KENDALL DR | ||||||||
| Address2: | MIAMI CANCER INSTITUTE | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865962000 | ||||||||
| FaxNumber: | 3052797778 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2014 | ||||||||
| LastUpdateDate: | 11/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 2022041960 | MO | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.