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General NPI Number Information
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NPI Number | 1164474235
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Entity Type | Organization
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Legal Business Name | GAINESVILLE HEMATOLOGY ONCOLOGY ASSOCIATES
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 1147 NW 64TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32605-4218
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Country | US
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Telephone | 352-332-3900
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Fax | 352-332-5009
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Provider Business Mailing Address
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Address Line | 1147 NW 64TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32605-4218
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Country | US
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Telephone | 352-332-3900
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Fax | 352-332-5009
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARCY MEDLIN
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Credential |
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Telephone | 352-332-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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