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General NPI Number Information
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NPI Number | 1275832974
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Entity Type | Organization
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Legal Business Name | HEMONC CONSULTANTS
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 2321 BUCKINGHAM RUN CT
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City | ORLANDO
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State | FL
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Zip | 32828-7837
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Country | US
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Telephone | 407-384-2692
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Fax |
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Provider Business Mailing Address
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Address Line | 2321 BUCKINGHAM RUN CT
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City | ORLANDO
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State | FL
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Zip | 32828-7837
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Country | US
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Telephone | 407-384-2692
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Fax |
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Authorized Official
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Title or Position | HEMATOLOGIST/ONCOLOGIST
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Name | PRIYA SHIVA VISHNUBHOTLA
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Credential | M.D.
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Telephone | 407-666-8024
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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 | ME93654
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License Number State | FL
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