GULFSHORE UROLOGY LLC (NPI# 1306209200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306209200 |
| Entity Type | Organization |
| Organization Name | GULFSHORE UROLOGY LLC |
| Practice Address |
28930 Trails Edge Blvd Suite 200 Bonita Springs FL 34134-7582 |
| Practice Telephone | 2393333200 |
| Practice Fax Number | 2399925785 |
| Mailing Telephone | 2393333200 |
| Mailing Fax Number | 2399925785 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |
| Authorized Official Name | DR. ROLANDO RIVERA (SHAREHOLDER) |
| Authorized Official Telephone | 2393333200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Street Address |
28930 TRAILS EDGE BLVD SUITE 200 |
| City | BONITA SPRINGS |
| State | FL |
| Zip Code | 34134-7582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073768990 | Jessica Lynn Anderson-riddell | Nurse Practitioner | 28930 Trails Edge Blvd, Suite 200, Bonita Springs, FL 34134-7518 | 2008-11-19 |
| 1639650161 | Trails Edge Surgery Center, LLC | Clinic/Center | 28930 Trails Edge Blvd, Bonita Springs, FL 34134-7582 | 2018-08-23 |
| 1659711018 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 28930 Trails Edge Blvd, Bonita Springs, FL 34134-7582 | 2013-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255803706 | Sheila Mourick | Home Health | 3920 Via Del Ray, Suite 4, Bonita Springs, FL 34134 | 2018-12-21 |
| 1447702162 | Averie Bendana | Hearing Instrument Specialist | 15 8th St Suite B, Hoglund Family Hearing, Bonita Springs, FL 34134 | 2016-10-28 |
| 1366990830 | Jordania Psychiatry LLC | Clinic/Center | 25111 Pennyroyal Dr, Bonita Springs, FL 34134 | 2016-09-14 |
| 1447682497 | Shancy Varghese Kanacheril | Pharmacist | 25121 S. Tamiami Trail, Bonita Springs, FL 34134 | 2013-08-01 |
| 1861762163 | Alyssa Haraczy | Pharmacist | 25121 S. Tamiami Trl, Bonita Springs, FL 34134 | 2012-01-04 |
| 1982905659 | Jessica Ann Rosen | Speech-Language Pathologist | 3384 Woods Edge Cir Ste 104, Bonita Springs, FL 34134 | 2010-11-10 |
| 1902116718 | Keenan Chiropractic Pa | Chiropractor | 3388 Woods Edge Circle Suite 102, Bonita Springs, FL 34134 | 2010-10-14 |
| 1659683076 | Amy Marie Mcneal | Massage Therapist | 28811 S. Tamiami Trail Unit 13-14, Bonita Springs, FL 34134 | 2010-07-14 |
| 1740509157 | Sarah Churton | Dermatology | 23471 Walden Center Drive, Suite 300, Bonita Springs, FL 34134 | 2010-05-25 |
| 1609003516 | Ram Prasad Kafle | Family Medicine | 26800 S Tamiami Trl Ste 340, Bonita Springs, FL 34134 | 2009-06-18 |
| Find all providers in zip 34134 | ||||
| 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 |
|---|---|---|---|---|
| 1669610564 | Cambridge Medical Clinic of Florida, LLC | Urology | 3501 Health Springs Blvd #2130, Bonita Springs, FL 34135 | 2009-01-30 |
| 1184644908 | Specialists In Urology | Urology | 28930 Trails Edge Blvd., 200, Bonita Springs, FL 34134 | 2006-07-21 |
| 1477602068 | Joanna K Chon | Urology | 3291 Woods Edge Pkwy, Suite 100, Bonita Springs, FL 34134-1301 | 2007-01-10 |
| 1982760369 | Arturo Balandra | Urology | 26800 S Tamiami Trl, Suite 250, Bonita Springs, FL 34134-4349 | 2006-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770193450 | Urotelemedicine LLC | Urology | 8669 Nw 36th St Ste 325, Doral, FL 33166-6698 | 2020-08-06 |
| 1700411618 | Ackerman Cancer Center, Pa | Urology | 159 North 3rd St, Macclenny, FL 32063-2103 | 2020-03-11 |
| 1043844483 | Jesse Aaron Ory | Urology | 5555 Ponce De Leon Blvd Fl 4, Coral Gables, FL 33146-2513 | 2020-02-25 |
| 1215591565 | Advent Health | Urology | 420 Celebration Ave, Celebration, FL 34747-4683 | 2019-04-23 |
| 1710442264 | Urologic Specialists of Central Florida Pllc | Urology | 575 S Wickham Rd Ste A, West Melbourne, FL 32904-1170 | 2019-02-08 |
| 1578028197 | Prody Urology, Pllc | Urology | 575 S Wickham Rd Ste B, West Melbourne, FL 32904-1170 | 2019-02-07 |
| 1366916843 | Dr. Carolyn Langford Urologic Solutions, LLC | Urology | 9400 Gladiolus Dr Ste 30, Fort Myers, FL 33908-9615 | 2019-01-17 |
| 1376016568 | Advanced Innovative Urology Pa | Urology | 4737 N Ocean Dr Ste 103, Lauderdale By The Sea, FL 33308-2920 | 2019-01-10 |
| 1306314281 | Urology Consultants of Boca Raton Pa | Urology | 825 Meadows Rd Ste 111, Boca Raton, FL 33486-2347 | 2018-11-08 |
| 1013490309 | Seetharam Bhat Kulthe Ramesh | Urology | 401 Celebration Pl Ste 200, Celebration, FL 34747-4971 | 2018-09-12 |
| Find all providers with the same taxonomy | ||||
| City | BONITA SPRINGS |
| Zip Code | 34134 |
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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.