VENKAT PAVAN REDDY KANCHARLA
Internal Medicine (Medical Oncology)

Address: 20 San Filippo Dr Se, Palm Bay, FL 32909-2200

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification Group License Number License State Taxonomy Group
Y 207RX0202X Internal Medicine
Specialization: Medical Oncology
ME112590 FL Allopathic & Osteopathic Physicians

Other Provider Identifiers

Identifier State Issuer Type Code
004704200 FL MEDICAID

Provider Secondary Practice Locations

Address Telephone Number Fax Number
1264 Malabar Rd Se, Palm Bay, FL 329072556 3217258300 3217251555

Physician Overview

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

Office Location

Street Address 20 SAN FILIPPO DR SE
City PALM BAY
State FL
Zip Code 32909-2200

Providers in the same location

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

Providers in the same zip code prefix

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 Information

Taxonomy Code 207RX0202X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Medical Oncology

Taxonomy Definition

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]

Providers in the same taxonomy and state

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

Competitor

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City PALM BAY
Zip Code 32909

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Dataset Information

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.

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