Healthcare Provider Details

I. General information

NPI: 1366600421
Provider Name (Legal Business Name): ADVANCED PHYSICIAN SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5347 MAIN ST SUITE 203
NEW PORT RICHEY FL
34652-2506
US

IV. Provider business mailing address

5347 MAIN ST SUITE 203
NEW PORT RICHEY FL
34652-2506
US

V. Phone/Fax

Practice location:
  • Phone: 727-849-6690
  • Fax:
Mailing address:
  • Phone: 727-849-6690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. NEIL BEDI
Title or Position: MANAGING MEMBER
Credential:
Phone: 941-284-7264