Provider Demographics
NPI:1588730477
Name:PASCO HERNANDO ONCOLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:PASCO HERNANDO ONCOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:KAPISTHALAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-842-2795
Mailing Address - Street 1:5802 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-6050
Mailing Address - Country:US
Mailing Address - Phone:727-842-2795
Mailing Address - Fax:727-842-8676
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:2006-11-24
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063696701Medicaid
FL98604OtherBCBS
FL063696700Medicaid
FL98604AOtherBCBS
FLCA3287OtherRR
FLCC5810OtherRR
FLCA3287OtherRR
FLCC5810OtherRR
FL063696700Medicaid