Provider Demographics
NPI:1013103084
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:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VENKATA
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:EMANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-862-5489
Mailing Address - Street 1:13904 LAKESHORE BLVD
Mailing Address - Street 2:STE 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 1:13904 LAKESHORE BLVD
Practice Address - Street 2:STE 410
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-1481
Practice Address - Country:US
Practice Address - Phone:727-862-5489
Practice Address - Fax:727-862-0397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378675700Medicaid
FL378675700Medicaid