Provider Demographics
NPI:1891705760
Name:HEMATOLOGY & ONCOLOGY CONSULTANTS OF TAMPA BAY P A
Entity Type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY CONSULTANTS OF TAMPA BAY P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-254-4233
Mailing Address - Street 1:2111 W SWANN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2477
Mailing Address - Country:US
Mailing Address - Phone:813-254-4233
Mailing Address - Fax:813-254-2434
Practice Address - Street 1:2111 W SWANN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2477
Practice Address - Country:US
Practice Address - Phone:813-254-4233
Practice Address - Fax:813-254-2434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
99136Medicare PIN