Provider Demographics
NPI:1366649881
Name:TAMPA BAY ONCOLOGY-HEMATOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:TAMPA BAY ONCOLOGY-HEMATOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-876-0035
Mailing Address - Street 1:4910 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1402
Mailing Address - Country:US
Mailing Address - Phone:813-876-0035
Mailing Address - Fax:813-876-2363
Practice Address - Street 1:4910 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1402
Practice Address - Country:US
Practice Address - Phone:813-876-0035
Practice Address - Fax:813-876-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD53859Medicare UPIN
FL30115Medicare ID - Type Unspecified