21ST CENTURY ONCOLOGY LLC (NPI# 1134109747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134109747 |
| Entity Type | Organization |
| Organization Name | 21ST CENTURY ONCOLOGY LLC |
| Practice Address |
7341 Gladiolus Dr Fort Myers FL 33908-5122 |
| Mailing Address |
2160 Colonial Blvd Fort Myers FL 33907-1410 |
| Practice Telephone | 2394893420 |
| Practice Fax Number | 2394893219 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2020-09-11 |
| Authorized Official Name | DAN COLLINS (PRESIDENT) |
| Authorized Official Telephone | 2399317275 |
| Is Organization Subpart | Y |
| Parent Organization Name | GENESISCARE USA INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 060239600 | 05 | |
| FL | 060239607 | 05 | |
| FL | 060239612 | 05 | |
| FL | 060239621 | 05 | |
| FL | 060239606 | 05 | |
| FL | 060239609 | 05 | |
| FL | 060239611 | 05 | |
| FL | 060239617 | 05 | |
| FL | 060239619 | 05 | |
| FL | RAILROAD MEDICARE | CE9586 | 01 |
| FL | 060239601 | 05 | |
| FL | 060239602 | 05 | |
| FL | 060239604 | 05 | |
| FL | 060239615 | 05 | |
| FL | RAILROAD MEDICARE | CE7138 | 01 |
| FL | 060239608 | 05 | |
| FL | 060239605 | 05 | |
| FL | 060239616 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740748706 | 21st Century Oncology LLC | Internal Medicine | 3651 Fau Blvd Ste 100, Boca Raton, FL 33431-6489 | 2019-03-08 |
| 1669701918 | 21st Century Oncology LLC | Urology | 1044 Goodlette Rd N, Naples, FL 34102-5449 | 2009-12-16 |
| 1790993632 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 1255 Viscaya Pkwy # 2, Suite 201, Cape Coral, FL 33990-3290 | 2007-05-21 |
| 1316426281 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 1200 E Broward Blvd, Fort Lauderdale, FL 33301-2134 | 2018-08-10 |
| 1922456722 | 21st Century Oncology LLC | Surgery | 10141 Forest Hill Blvd, Wellington, FL 33414-6103 | 2016-06-02 |
| 1568820363 | 21st Century Oncology LLC | Surgery | 3300 Us 27 S, Avon Park, FL 33825-9701 | 2016-02-08 |
| 1558729855 | 21st Century Oncology LLC | Surgery | 6405 N Federal Hwy, Suite 401, Fort Lauderdale, FL 33308-1412 | 2016-02-02 |
| 1730551227 | 21st Century Oncology LLC | Surgery | 1411 N Flagler Dr, Suite 7300, West Palm Beach, FL 33401-3404 | 2015-10-23 |
| 1679945158 | 21st Century Oncology LLC | Urology | 787 37th St, Suite E-200, Vero Beach, FL 32960-7305 | 2015-10-23 |
| 1871964916 | 21st Century Oncology LLC | Urology | 10115 Forest Hill Blvd, Suite 100, Wellington, FL 33414-3105 | 2015-10-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | 21ST CENTURY ONCOLOGY LLC | 3651 Fau Blvd Ste 100, Boca Raton, FL 33431-6489 |
| Street Address |
7341 GLADIOLUS DR |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33908-5122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043214539 | Peter H. Blitzer | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5122 | 2005-06-13 |
| 1518597848 | Inesa Sviridova | Physician Assistant | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2020-01-26 |
| 1205209707 | Drutika S Patel | Physician Assistant | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2015-11-05 |
| 1750774436 | Rikki Floyd | Physician Assistant | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2015-03-05 |
| 1326398488 | Nicole B Houle | Nurse Practitioner | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2012-09-17 |
| 1609079151 | Jason T Shumadine | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2007-06-11 |
| 1699832550 | Beth A. Patrizi | Nurse Practitioner | 7341 Gladiolus Dr, Fort Myers, FL 33908-5122 | 2007-01-02 |
| 1619043700 | May Lynne Foo | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2006-11-28 |
| 1760463061 | David E. Lee | Physician Assistant | 7341 Gladiolus Dr, Fort Myers, FL 33908-5122 | 2005-11-14 |
| 1356348072 | Keith L. Miller | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5122 | 2005-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081806 | 1 Recovery | Community/Behavioral Health | 111 Daniels Dr, Fort Myers, FL 33908 | 2020-10-20 |
| 1457916462 | Avipharm, LLC | Pharmacy | 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 | 2019-05-06 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1730665167 | Kyndra Lynn Petrick | Psychiatry & Neurology | 8560 Big Mangrove Dr, Fort Myers, FL 33908 | 2018-07-18 |
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1619497062 | Vanesa Paola Vaquer | Dentist | 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 | 2017-06-26 |
| 1962859603 | Teresa Ruiz | Behavior Technician | 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 | 2016-05-23 |
| 1669865721 | Elena B. Alexiev | Dentist | 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 | 2015-03-13 |
| 1134488919 | Cecelia Anne Collins | Dietitian, Registered | 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 | 2012-05-14 |
| Find all providers in zip 33908 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609873785 | Patrick M Francke | Radiology | 2234 Colonial Blvd, Fort Myers, FL 33907-1412 | 2005-07-05 |
| 1811994999 | Michael J. Katin | Radiology | 15681 New Hampshire Ct, Fort Myers, FL 33908-4123 | 2005-07-05 |
| 1043214539 | Peter H. Blitzer | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5122 | 2005-06-13 |
| 1396398756 | Axis Radiation Oncology, LLC | Radiology | 15681 New Hampshire Ct, Fort Myers, FL 33908-4123 | 2019-07-24 |
| 1720303589 | Arie P. Dosoretz | Radiology | 15681 New Hampshire Ct, Fort Myers, FL 33908-4123 | 2010-04-05 |
| 1609079151 | Jason T Shumadine | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2007-06-11 |
| 1619043700 | May Lynne Foo | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2006-11-28 |
| 1922098045 | Alan L Brown Jr. | Radiology | 15681 New Hampshire Ct, Fort Myers, FL 33908-4123 | 2005-10-28 |
| 1194710384 | James H. Rubenstein | Radiology | 15681 New Hampshire Ct, Fort Myers, FL 33908-4123 | 2005-09-14 |
| 1356348072 | Keith L. Miller | Radiology | 7341 Gladiolus Dr, Fort Myers, FL 33908-5122 | 2005-07-07 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33908 |
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| 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.