Organization Active NPI

Pediatric Hematology/Oncology ASC PA

  • Pediatric Hematology & Oncology Physician
  • St Petersburg, FL
National Provider Identifier
1477511970
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
Legal business name
PEDIATRIC HEMATOLOGY/ONCOLOGY ASC PA
Practice address
880 6TH St S
Suite 140
St Petersburg, FL 33701-4827
Phone
(727) 767-4231
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jerry L Barbosa, M.D.
Title
Medical Director
Phone
(727) 767-4231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0207X Primary

Addresses

Primary practice location

880 6TH St S
Suite 140
St Petersburg, FL 33701-4827

Mailing address

880 6TH St S
Suite 140
St Petersburg, FL 33701-4827
Phone (727) 767-4231

Other identifiers 2

IdentifierTypeStateIssuer
59684OtherFLAETNA
24216OtherFLBCBS

National Provider Directory

National Provider Directory

Locations

880 6th St S
Ste 140
St Petersburg, FL 33701
Phone (727) 767-4176

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477511970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 6TH ST S",
            "address_2": "SUITE 140",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014827",
            "telephone_number": "727-767-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 6TH ST S",
            "address_2": "SUITE 140",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014827",
            "telephone_number": "727-767-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEMATOLOGY/ONCOLOGY ASC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARBOSA",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "727-767-4231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "59684",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "24216",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.