MEDICARE: RAMBABU TUMMALA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RX0202X	Medical Oncology Physician	ME71127	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	830003186	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31507	OTHER		BC BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295716645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMBABU TUMMALA MD

Provider Business Mailing Address
First Line	:	9832 US HWY 441
Second Line	:	SUITE 101
City	:	LEESBURG
State	:	FL
Zip	:	34788
Country	:	US
Telephone Number	:	352-787-3341
Fax Number	:	352-787-7491

Provider Business Practice Location Address
First Line	:	9832 US HWY 441
Second Line	:	SUITE 101
City	:	LEESBURG
State	:	FL
Zip	:	34788
Country	:	US
Telephone Number	:	352-787-3341
Fax Number	:	352-787-7491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	11/23/2021

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Directions to “ RAMBABU TUMMALA MD” Practice Location

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