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General NPI Number Information
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NPI Number | 1629229646
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Entity Type | Organization
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Legal Business Name | NMC LLC
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 621 LUMSDEN PROFESSIONAL CT
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City | BRANDON
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State | FL
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Zip | 33511-5996
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Country | US
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Telephone | 813-657-4004
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Fax |
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Provider Business Mailing Address
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Address Line | 621 LUMSDEN PROFESSIONAL COURT
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City | BRANDON
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State | FL
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Zip | 33511-5996
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Country | US
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Telephone | 813-574-1465
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | DR. RANDY KAHN
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Credential | M.D.
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Telephone | 813-574-1465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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