VENKAT PAVAN REDDY KANCHARLA (NPI# 1205091758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205091758 |
| Entity Type | Individual |
| Full Name | VENKAT PAVAN REDDY KANCHARLA |
| Gender | Male |
| Credential | M.D |
| Practice Address | 20 San Filippo Dr Se Palm Bay FL 32909-2200 |
| Practice Telephone | 3217258300 |
| Practice Fax Number | 3217251555 |
| Mailing Address | Po Box 534595 Atlanta GA 30353-4595 |
| Mailing Telephone | 3217258300 |
| Mailing Fax Number | 3217251555 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2019-01-07 |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 207RX0202X | Internal Medicine Specialization: Medical Oncology | ME112590 | FL | Allopathic & Osteopathic Physicians |
| Identifier | State | Issuer | Type Code |
|---|---|---|---|
| 004704200 | FL | MEDICAID |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1264 Malabar Rd Se, Palm Bay, FL 329072556 | 3217258300 | 3217251555 |
| PECOS Associate Control (PAC) ID | 5799852398 by Medicare Provider Enrollment and Chain/Ownership System (PECOS) |
| Professional Enrollment ID | I20120606000179 |
| Last Name | KANCHARLA |
| First Name | VENKAT PAVAN |
| Middle Name | R |
| Organization Legal Name | CANCER CARE CENTERS OF BREVARD INC |
| Location | 1430 S Pine St, Melbourne, FL 32901-3119 |
| Phone Number | 3219520898 |
| Graduation Year | 1998 |
| Primary Specialty | MEDICAL ONCOLOGY |
| Group Practice PAC ID | 3274435102 |
| Number of Group Practice Members | 12 |
| Street Address | 20 SAN FILIPPO DR SE |
| City | PALM BAY |
| State | FL |
| Zip Code | 32909-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437050 | Rachel Mccleve | Nurse Practitioner · Acute Care | 20 San Filippo Dr Se, Palm Bay, FL 32909-2200 | 2019-09-26 |
| 1891855532 | Katie L Wilkerson | Nurse Practitioner | 20 San Filippo Dr Se, Palm Bay, FL 32909-2200 | 2006-12-11 |
| 1952362816 | Gregory B Hoang | Internal Medicine · Hematology & Oncology | 20 San Filippo Dr Se, Palm Bay, FL 32909-2200 | 2006-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447349 | Sarah Nicosia | Registered Nurse | 2752 Palisades Dr, Palm Bay, FL 32909 | 2020-08-12 |
| 1447881297 | Shangri-La of Palm Bay Alf, LLC | Assisted Living Facility | 3604 Jupiter Blvd. Se, Palm Bay, FL 32909 | 2020-01-30 |
| 1972094357 | Mindful Counseling and Wellness LLC | Social Worker · Clinical | 221 Devlin Ct Se, Palm Bay, FL 32909 | 2018-05-22 |
| 1306348859 | Mallory Kathleen Herndon · Mallory Kathleen Herndon | Behavior Technician | 458 Barcelona Rd, Palm Bay, FL 32909 | 2018-03-01 |
| 1548786627 | Chotsani Merrill · Chotsani Ayala | Home Health Aide | 781 Davenport St Se, Palm Bay, FL 32909 | 2017-08-21 |
| 1639629538 | Maggie Cameron | Clinic/Center · Developmental Disabilities | 2511 Quentin Ave Ne, Palm Bay, FL 32909 | 2016-10-04 |
| 1194195016 | Dawn Goodwin | Pharmacist | 3450 Bayside Lakes Shopping Center, Palm Bay, FL 32909 | 2015-10-05 |
| 1124407796 | Jorge Ortiz | Physical Therapist | 470 Malabar Rd Se, Ste 102, Palm Bay, FL 32909 | 2015-05-28 |
| 1932506227 | Annalisa Tietjen I | Dental Hygienist | 714 Ave C, Fort Pierce, FL 32909 | 2014-12-02 |
| 1194147611 | Carl Glenmore Morrison Sr. | General Practice | 2125 Windbrook Drive, Palm Bay, FL 32909 | 2014-01-17 |
| Find all providers in zip 32909 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508458951 | Tampa General Medical Group Inc | 2 Tampa General Cir Fl 3, Tampa, FL 33606-3571 | 2021-02-08 | |
| 1750972527 | Genesiscare Usa of Florida LLC · Genesiscare Center for Oncology | 3700 Washington St Ste 100, Hollywood, FL 33021-8213 | 2021-02-03 | |
| 1568079648 | The Oncology Institute Fl, LLC | 2105 W Watrous Ave, Tampa, FL 33606-3046 | 2020-09-23 | |
| 1821626383 | Tampa General Medical Group Inc · Tampa General Hospital-Cancer Care-New Tampa | 17416 Brookside Trace Ct, Tampa, FL 33647-3589 | 2020-03-31 | |
| 1043841059 | American Oncology Partners of Maryland, Pa · Center for Cancer & Blood Disorders | 9160 Forum Corporate Pkwy Ste 350, Fort Myers, FL 33905-7808 | 2020-01-29 | |
| 1205479862 | Tampa General Medical Group Inc | 10740 Palm River Rd Ste 360, Tampa, FL 33619-4578 | 2019-10-25 | |
| 1770143752 | Raul Vera-Gimon | 10730 Nw 66th St Apt 312, Doral, FL 33178-3708 | 2019-06-20 | |
| 1033776166 | Tampa General Medical Group Inc · Tampa General Hospital Cancer Care Riverview | 3140 S Falkenburg Rd, Riverview, FL 33578-2574 | 2019-05-23 | |
| 1740748706 | Genesiscare Usa of Florida LLC · Florida Precision Oncology | 3651 Fau Blvd Ste 100, Boca Raton, FL 33431-6489 | 2019-03-08 | |
| 1699243501 | Jose Armando Villamil | 8356 Sw 40th St Ste J, Miami, FL 33155-3356 | 2018-11-08 | |
| Find all providers in the same taxonomy | ||||
| City | PALM BAY |
| Zip Code | 32909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720134521 | Venkat K Reddy · Venkata K Reddy | Specialist | 1804 State St, Nashville, TN 37203-2206 | 2007-01-25 |
| 1932413259 | Adarsh Reddy Kancharla | Pediatrics | 101 E Wood St, Spartanburg, SC 29303-3040 | 2010-07-28 |
| 1568705135 | Malini Kancharla Reddy | Internal Medicine | 1061 Dowdy Rd, Ste 100, Athens, GA 30606 | 2013-04-02 |
| 1073629622 | Madhavi Reddy Kancharla | Internal Medicine | 358 N Broadway, Sleepy Hollow, NY 10591-2322 | 2006-08-23 |
| 1629067533 | Kiran Reddy Kancharla | Internal Medicine · Hematology & Oncology | 2021 N Macarthur Blvd Ste 400, Irving, TX 75061-2226 | 2005-10-14 |
| 1932161155 | Pavan S Reddy | Internal Medicine · Hematology & Oncology | 818 N Emporia St, Suite 403, Wichita, KS 67214-3729 | 2006-04-04 |
| 1457748840 | Pavan Reddy | Student in an Organized Health Care Education/Training Program | 1200 N State St, Los Angeles, CA 90033-1029 | 2015-04-23 |
| 1285194563 | Venkat Reddy Vaddamani | Student in an Organized Health Care Education/Training Program | 101 Stadium Dr, Morgantown, WV 26506-7911 | 2019-03-22 |
| 1265644041 | Venkat N Reddy | Dentist · General Practice | 10401 Old Georgetown Rd, 210, Bethesda, MD 20814 | 2007-05-04 |
| 1619143807 | Pavan G Reddy Md Pllc | Otolaryngology | 14500 Northline Rd, Southgate, MI 48195-2402 | 2008-05-07 |
Please provide details on VENKAT PAVAN REDDY KANCHARLA by submitting the form below, or post on facebook comments.
Note that the information provided will be posted publicly on this web page. Please do not leave private contact information here. If you would like to contact us, please use this form.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.