MEDICARE: PASCO HERNANDO ONCOLOGY ASSOCIATES PA

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	98604	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	98604A	OTHER	FL	BCBS
5	CA3287	OTHER	FL	RR
6	CC5810	OTHER	FL	RR

General Provider Information

NPI Number	:	1588730477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASCO HERNANDO ONCOLOGY ASSOCIATES PA

Provider Business Mailing Address
First Line	:	5802 STATE ROAD 54
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-6050
Country	:	US
Telephone Number	:	727-842-2795
Fax Number	:	727-842-8676

Provider Business Practice Location Address
First Line	:	5802 STATE ROAD 54
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-6050
Country	:	US
Telephone Number	:	727-842-2795
Fax Number	:	727-842-8676

Authorized Official
Title or Position	:	M.D.
Name	:	DR. KAPISTHALAM S. KUMAR
Credential	:
Telephone Number	:	727-842-2795

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	06/23/2010

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Directions to “PASCO HERNANDO ONCOLOGY ASSOCIATES PA ” Practice Location

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