Healthcare Provider Details

I. General information

NPI: 1013908490
Provider Name (Legal Business Name): VERO BEACH HEMATOLOGY ONCOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 37TH PL
VERO BEACH FL
32960-6541
US

IV. Provider business mailing address

981 37TH PL
VERO BEACH FL
32960-6541
US

V. Phone/Fax

Practice location:
  • Phone: 772-299-4255
  • Fax: 772-299-3580
Mailing address:
  • Phone: 772-299-4255
  • Fax: 772-299-3580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME0077699
License Number StateFL

VIII. Authorized Official

Name: HEMA NAGANEMI RAO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 772-299-4255