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Organization
EAST LAKE ONCOLOGY
Active
Organization
EAST LAKE ONCOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
D. ANDA NORBERGS M.D. (PRESIDENT)
(727) 789-2595
Entity
Organization
Contact information
Practice address
4114 WOODLANDS PKWY, SUITE 301, PALM HARBOR, FL 34685-3450
(727) 789-2595
(727) 789-8891
Mailing address
4114 WOODLANDS PKWY, SUITE 301, PALM HARBOR, FL 34685-3450
(727) 789-2595
(727) 789-8891
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME0056118
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09165
BCBSFL
FL
01
—
09165Y
MEDICARE UNSPEC
FL
01
—
DG4665
RRW MEDICARE
—
Enumeration date
05/17/2007
Last updated
01/28/2008
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