Provider Demographics
NPI:1962450486
Name:V UPENDER RAO MD PA
Entity Type:Organization
Organization Name:V UPENDER RAO MD PA
Other - Org Name:CANCER & BLOOD DISEASE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:V
Authorized Official - Middle Name:UPENDER
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-746-0707
Mailing Address - Street 1:521 N LECANTO HWY
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-9187
Mailing Address - Country:US
Mailing Address - Phone:352-746-0707
Mailing Address - Fax:352-746-6333
Practice Address - Street 1:521 NO LECANTO HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461
Practice Address - Country:US
Practice Address - Phone:352-746-0707
Practice Address - Fax:352-746-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052777700Medicaid
FL0599600001Medicare NSC
FL052777700Medicaid