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NPI Code Detail

MEDICARE: CENTER FOR RADIATION ONCOLOGY OF TAMPA BAY IN

MEDICARE: CENTER FOR RADIATION ONCOLOGY OF TAMPA BAY IN
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
12085R0001XRadiation Oncology Physician59-3204668FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972500841
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR RADIATION ONCOLOGY OF TAMPA BAY IN
Provider Business Mailing Address
First Line : 2715 WEST VIRGINIA AVENUE
Second Line :
City : TAMPA
State : FL
Zip : 33607-6327
Country : US
Telephone Number : 813-662-6024
Fax Number : 813-514-1257
Provider Business Practice Location Address
First Line : 7315 GREEN SLOPE DR
Second Line :
City : ZEPHYRHILLS
State : FL
Zip : 33541-1314
Country : US
Telephone Number : 813-783-8614
Fax Number : 813-783-8538
Authorized Official
Title or Position : VP INDIANA AND SOUTH FLORIDA OPERAI
Name : MR. NICK L HERNANDEZ
Credential : MBA, FACHE
Telephone Number : 813-662-6024
Provider Enumeration Date : 07/07/2005
Last Update Date : 11/01/2012

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Directions to “CENTER FOR RADIATION ONCOLOGY OF TAMPA BAY IN ” Practice Location

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