Provider Demographics
NPI:1326198912
Name:ONCOLOGY ASSOCIATION PA
Entity Type:Organization
Organization Name:ONCOLOGY ASSOCIATION PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-872-0613
Mailing Address - Street 1:4700 N HABANA AVE
Mailing Address - Street 2:SUITE 702
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7160
Mailing Address - Country:US
Mailing Address - Phone:813-872-0613
Mailing Address - Fax:813-879-2644
Practice Address - Street 1:4700 N HABANA AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7160
Practice Address - Country:US
Practice Address - Phone:813-872-0613
Practice Address - Fax:813-879-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069298100Medicaid
FLK5944Medicare ID - Type UnspecifiedGROUP PRACTICE
FLD54084Medicare UPIN