21ST CENTURY ONCOLOGY LLC (NPI# 1275917304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275917304 |
| Entity Type | Organization |
| Organization Name | 21ST CENTURY ONCOLOGY LLC |
| Other Organization Name | GULFSHORE UROLOGY |
| Practice Address |
4571 Colonial Blvd Fort Myers FL 33966-1156 |
| Mailing Address |
2234 Colonial Blvd Fort Myers FL 33907-1412 |
| Practice Telephone | 2393225600 |
| Practice Fax Number | 2393225610 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2019-07-15 |
| Authorized Official Name | KIM COMMINS (CEO) |
| Authorized Official Telephone | 2399317277 |
| Is Organization Subpart | Y |
| Parent Organization Name | 21ST CENTURY ONCOLOGY INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Gulfshore Urology | Doing Business As Name - Organization |
| 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 |
4571 COLONIAL BLVD |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33966-1156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093713489 | Jacob H Goldberger | Surgery | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2005-07-11 |
| 1760963292 | Colonial Outpatient Surgery Center, LLC | Clinic/Center | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2018-08-23 |
| 1528442332 | Genesiscare of Florida LLC | Otolaryngology | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2015-07-13 |
| 1306274063 | Mark Monzone | Physician Assistant | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2013-10-16 |
| 1588005383 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2013-07-10 |
| 1700140878 | Specialists In Urology, P.a. | Urology | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966-1156 | 2012-07-03 |
| 1912209800 | Specialists In Urology Surgery Center LLC | Clinic/Center | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966 | 2010-11-26 |
| 1861707275 | Megan Lavender Menster | Nurse Practitioner | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2010-08-10 |
| 1124258983 | Meagan M Walton | Nurse Practitioner | 4571 Colonial Blvd, Suite 100, Fort Myers, FL 33966-1156 | 2009-07-15 |
| 1801038070 | Scott Von Larson | Otolaryngology | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2009-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962989566 | Samarah A Al-jamali | Dentist | 9330 Ben Pratt/6 Mi Cypress #4, Fort Myers, FL 33966 | 2018-07-26 |
| 1932646171 | Jose M Butron | Behavioral Analyst | 6430 Plantation Park Ct Ste 200, Fort Myers, FL 33966 | 2017-01-26 |
| 1003276833 | Katia Jasmin Robinson Lucero | Social Worker | 3820 Colonial Blvd Suite #102, Fort Myers, FL 33966 | 2016-03-07 |
| 1578947610 | Christian Milanes | Dentist | 9330 Ben C. Pratt Six Mile Cypress Pkwy, Fort Myers, FL 33966 | 2015-07-18 |
| 1003166273 | Reetane Singh | Dentist | 9330 Ben C Pratt Six Mile, Cypress Parkway, Fort Myers, FL 33966 | 2012-09-14 |
| 1518216159 | Lee Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 10140 Deer Run Farms Road, Fort Myers, FL 33966 | 2012-08-29 |
| 1033482724 | Planned Parenthood of Southwest and Central Florida Inc. | Obstetrics & Gynecology | 6418 Commerce Park Drive, Fort Myers, FL 33966 | 2012-02-11 |
| 1013292291 | J Kru Therapy LLC Dba Focus | Physical Therapist | 4997 Royal Gulf Cir, Fort Myers, FL 33966 | 2011-10-19 |
| 1528354651 | American In-home Care, LLC | Home Health | 3800 Colonial Blvd Unit 102, Fort Myers, FL 33966 | 2011-06-27 |
| 1811219256 | Vera Marie Rosado-odom | Internal Medicine | 13340 Metro Pkwy Ste 310, Fort Myers, FL 33966 | 2010-02-26 |
| Find all providers in zip 33966 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366916843 | Dr. Carolyn Langford Urologic Solutions, LLC | Urology | 9400 Gladiolus Dr Ste 30, Fort Myers, FL 33908-9615 | 2019-01-17 |
| 1427388065 | Davis Fessenden Gates | Urology | 1255 Osceola Dr, Fort Myers, FL 33901-6729 | 2010-01-04 |
| 1386656528 | Meir Daller | Urology | 14320 Metropolis Ave Ste 1, Fort Myers, FL 33912-4539 | 2006-08-13 |
| 1326054131 | Lewis B Chaikin | Urology | 4048 Evans Ave Ste 306, Fort Myers, FL 33901-9390 | 2006-08-01 |
| 1376558866 | Philip Newhall | Urology | 12651 Whitehall Dr, Fort Myers, FL 33907-3626 | 2006-07-31 |
| 1538185939 | Veronique Fernandez-salvador | Urology | 7451 Gladiolus Dr, Fort Myers, FL 33908-5193 | 2006-07-15 |
| 1215913975 | David S Harris | Urology | 6811 Palisades Park Ct Ste 1, Fort Myers, FL 33912 | 2005-12-15 |
| 1548810823 | Bradley J Trifilo | Urology | 14320 Metropolis Ave Ste 1, Fort Myers, FL 33912-4539 | 2019-09-18 |
| 1558737148 | Scappa Urology, Pa | Urology | 9400 Gladiolus Dr, Suite 30, Fort Myers, FL 33908-6699 | 2015-08-18 |
| 1053703454 | 21st Century Oncology LLC | Urology | 8931 Colonial Center Dr, Suite 100, Fort Myers, FL 33905-7809 | 2015-02-23 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33966 |
Please comment or provide details below to improve the information on 21ST CENTURY ONCOLOGY LLC.
| 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.