Provider Demographics
NPI:1528610367
Name:COMPREHENSIVE HEMATOLOGY ONCOLOGY LLC
Entity type:Organization
Organization Name:COMPREHENSIVE HEMATOLOGY ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRED
Authorized Official - Prefix:
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-799-0046
Mailing Address - Street 1:5000 PARK ST N STE 1025
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2236
Mailing Address - Country:US
Mailing Address - Phone:727-344-6569
Mailing Address - Fax:727-384-4388
Practice Address - Street 1:5000 PARK ST N STE 1025
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2236
Practice Address - Country:US
Practice Address - Phone:727-344-6569
Practice Address - Fax:727-384-4388
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE HEMATOLOGY ONCOLOGY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy