Provider Demographics
NPI:1659338754
Name:Y NADIMINTI MD PA
Entity Type:Organization
Organization Name:Y NADIMINTI MD PA
Other - Org Name:ONCOLOGY HEMATOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FICO
Authorized Official - Suffix:
Authorized Official - Credentials:CMM
Authorized Official - Phone:941-748-2217
Mailing Address - Street 1:401 MANATEE AVE E
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1143
Mailing Address - Country:US
Mailing Address - Phone:941-748-2217
Mailing Address - Fax:941-748-5300
Practice Address - Street 1:401 MANATEE AVE E
Practice Address - Street 2:SUITE B
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1143
Practice Address - Country:US
Practice Address - Phone:941-748-2217
Practice Address - Fax:941-748-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72881Medicare ID - Type UnspecifiedFL MEDICARE