Provider Demographics
NPI:1164416384
Name:BLOOD AND CANCER CENTER, PA
Entity Type:Organization
Organization Name:BLOOD AND CANCER CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANJU
Authorized Official - Middle Name:
Authorized Official - Last Name:VASUDEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-732-3005
Mailing Address - Street 1:1040 SW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-4226
Mailing Address - Country:US
Mailing Address - Phone:352-732-3005
Mailing Address - Fax:352-351-1507
Practice Address - Street 1:1040 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4226
Practice Address - Country:US
Practice Address - Phone:352-732-3005
Practice Address - Fax:352-351-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty