MEDICARE: CAMERON KAMRAN TEBBI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0207X	Pediatric Hematology & Oncology Physician	ME42258	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10218	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083619621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON KAMRAN TEBBI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 197770
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 TAMPA GENERAL CIR
Second Line	:	STC 2ND FLOOR
City	:	TAMPA
State	:	FL
Zip	:	33606-3603
Country	:	US
Telephone Number	:	813-259-8700
Fax Number	:	813-259-8862

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	06/08/2011

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