Organization
PEDIATRIC HEMATOLOGY/ONCOLOGY ASC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY L BARBOSA M.D. (MEDICAL DIRECTOR)
(727) 767-4231
Entity
Organization
Contact information
Practice address
880 6TH ST S, SUITE 140, ST PETERSBURG, FL 33701-4827
(727) 767-4231
Mailing address
880 6TH ST S, SUITE 140, ST PETERSBURG, FL 33701-4827
(727) 767-4231
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24216
BCBS
FL
01
—
59684
AETNA
FL
Enumeration date
05/03/2006
Last updated
08/22/2020
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