Organization
CANCER CENTERS OF CENTRAL FLORIDA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMBABU TUMMALA MD (PRESIDENT)
(352) 787-3341
Entity
Organization
Contact information
Practice address
9832 US HIGHWAY 441, STE 101, LEESBURG, FL 34788-3966
(352) 787-3341
(352) 787-7491
Mailing address
9832 US HIGHWAY 441, STE 101, LEESBURG, FL 34788-3966
(352) 787-3341
(352) 787-7491
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME71127
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259000000
—
FL
01
—
31507
FLORIDA BLUE
FL
Enumeration date
11/10/2005
Last updated
05/06/2014
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