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General NPI Number Information
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NPI Number | 1205438033
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE HEMATOLOGY ONCOLOGY LLC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 15211 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6072
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Country | US
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Telephone | 352-597-4998
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Fax | 352-596-6051
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Provider Business Mailing Address
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Address Line | 14690 SPRING HILL DR STE 101
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City | SPRING HILL
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State | FL
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Zip | 34609-8102
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Country | US
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Telephone | 352-799-0046
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Fax | 352-799-0042
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | PRATIBHA KIRIT DESAI
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Credential | MD
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Telephone | 727-344-6569
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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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