Healthcare Provider Details

I. General information

NPI: 1447345541
Provider Name (Legal Business Name): CLEARWATER HEMATOLOGY ONCOLOGY ASSOC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 PINELLAS STREET SUITE 330
CLEARWATER FL
33756-3809
US

IV. Provider business mailing address

303 PINELLAS ST SUITE 330
CLEARWATER FL
33756-3809
US

V. Phone/Fax

Practice location:
  • Phone: 727-447-8100
  • Fax: 727-461-2603
Mailing address:
  • Phone: 727-447-8100
  • Fax: 727-461-2603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 1435602
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME 59034
License Number StateFL

VIII. Authorized Official

Name: HITESH C PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-447-8100