MEDICARE: HEMATOLOGY & ONCOLOGY CONSULTANTS OF TAMPA BAY P A

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	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1891705760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMATOLOGY & ONCOLOGY CONSULTANTS OF TAMPA BAY P A

Provider Business Mailing Address
First Line	:	2111 W SWANN AVE
Second Line	:	SUITE 102
City	:	TAMPA
State	:	FL
Zip	:	33606-2477
Country	:	US
Telephone Number	:	813-254-4233
Fax Number	:	813-254-2434

Provider Business Practice Location Address
First Line	:	2111 W SWANN AVE
Second Line	:	SUITE 102
City	:	TAMPA
State	:	FL
Zip	:	33606-2477
Country	:	US
Telephone Number	:	813-254-4233
Fax Number	:	813-254-2434

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MR. ROBERT C KLEBER
Credential	:
Telephone Number	:	813-254-4233

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	12/13/2007

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