Provider Demographics
NPI:1073929402
Name:BETHEL BLOOD AND CANCER CENTER, P.A.
Entity Type:Organization
Organization Name:BETHEL BLOOD AND CANCER CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD, MRCP, FACP
Authorized Official - Phone:407-790-0993
Mailing Address - Street 1:3256 S PINE AVE
Mailing Address - Street 2:STE 303
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6605
Mailing Address - Country:US
Mailing Address - Phone:352-512-0688
Mailing Address - Fax:352-622-8812
Practice Address - Street 1:3256 S PINE AVE
Practice Address - Street 2:STE 303
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6605
Practice Address - Country:US
Practice Address - Phone:352-512-0688
Practice Address - Fax:352-622-8812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HW982AMedicare PIN