Provider Demographics
NPI:1932465317
Name:V RAO EMANDI MD PA
Entity Type:Organization
Organization Name:V RAO EMANDI MD PA
Other - Org Name:CANCER CARE CENTERS OF FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:PANARISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-862-7103
Mailing Address - Street 1:13904 LAKESHORE BLVD
Mailing Address - Street 2:#410
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-1481
Mailing Address - Country:US
Mailing Address - Phone:727-862-5489
Mailing Address - Fax:727-862-0397
Practice Address - Street 1:5802 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-6050
Practice Address - Country:US
Practice Address - Phone:727-842-2795
Practice Address - Fax:727-842-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36725174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378675700Medicaid
FL378675700Medicaid
FL1013103084Medicare NSC