21ST CENTURY ONCOLOGY LLC (NPI# 1871962720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871962720 |
| Entity Type | Organization |
| Organization Name | 21ST CENTURY ONCOLOGY LLC |
| Other Organization Name | SURGICAL SPECIALISTS OF SOUTH FLORIDA |
| Practice Address |
142 John F Kennedy Dr Lake Worth FL 33462-1159 |
| Mailing Address |
2234 Colonial Blvd Fort Myers FL 33907-1412 |
| Practice Telephone | 5614391500 |
| Practice Fax Number | 5614399902 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2019-07-12 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | CE7138 | 01 |
| Other Name | Type Code |
|---|---|
| Surgical Specialists of South Florida | 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 |
142 JOHN F KENNEDY DR |
| City | LAKE WORTH |
| State | FL |
| Zip Code | 33462-1159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578114658 | Erika Jamie Sirois-moreno | Nurse Practitioner | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2019-09-20 |
| 1891164208 | 21st Century Oncology LLC | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2015-09-16 |
| 1538437694 | Sfm Surgery V LLC | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2011-12-05 |
| 1891939385 | Alvaro Ernesto Castillo | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462 | 2009-04-28 |
| 1124263603 | Mark Joseph Meyer | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2008-12-11 |
| 1033319546 | Lori Ann Anthony | Physician Assistant | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2007-07-23 |
| 1710196936 | John D Corbitt Jr. | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449503 | Brightlife Institute, LLC | Clinic/Center | 2315 Shimmery Lane, Lake Worth, FL 33462 | 2020-05-20 |
| 1760024988 | Woodelyne Marc | Home Health | 1307 Flamingo Dr, Lantan, FL 33462 | 2019-10-09 |
| 1336624428 | Jennifer Lynn Jones | Nurse Practitioner | 5401 S Congress Ave Ste 105, Atlantis, FL 33462 | 2018-09-25 |
| 1427548445 | Publix Super Markets, Inc. | Pharmacy | 262 S Ocean Blvd, Manalapan, FL 33462 | 2018-05-15 |
| 1629567474 | Perfection Rx LLC | Pharmacy | 3248 Lantana Rd, Lake Worth, FL 33462 | 2018-05-08 |
| 1942797824 | Mayra Alejandra Tovar Castro | Student in an Organized Health Care Education/Training Program | 180 Jfk Drive, Suite 210, Atlantis, FL 33462 | 2018-04-17 |
| 1285131169 | Samar Ibrahim Mohamed Huss Aboulenain | Student in an Organized Health Care Education/Training Program | 180 Jfk Drive, Suite 210, Atlantis, FL 33462 | 2018-04-09 |
| 1801392535 | Carla Ortega | Student in an Organized Health Care Education/Training Program | 180 Jkf Drive, Suite 210, Atlantis, FL 33462 | 2018-04-02 |
| 1811427438 | Sonia Camille | Behavior Technician | 49 Sioux Ln, Lantana, FL 33462 | 2017-06-15 |
| 1922536648 | Alyzza De La Uz Forte | Nurse Practitioner | 180 John F Kennedy Dr, 311, Atlantis, FL 33462 | 2017-05-25 |
| Find all providers in zip 33462 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821618729 | Herbert Paul Lerner | Surgery | 10815 Royal Devon Way, Lake Worth, FL 33449-8650 | 2020-04-21 |
| 1972598563 | Steven G Goff | Surgery | 4665 S Congress Ave, 100, Lake Worth, FL 33461-4754 | 2005-09-20 |
| 1891164208 | 21st Century Oncology LLC | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2015-09-16 |
| 1538437694 | Sfm Surgery V LLC | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2011-12-05 |
| 1891939385 | Alvaro Ernesto Castillo | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462 | 2009-04-28 |
| 1124263603 | Mark Joseph Meyer | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2008-12-11 |
| 1003001488 | Fred L Simon Md Pa | Surgery | 4665 S Congress Ave, Suite 102, Lake Worth, FL 33461-4754 | 2007-09-10 |
| 1992900062 | Audley Lloyd Martin Osbourne | Surgery | 5065 State Road 7, Suite 203, Lake Worth, FL 33449-4615 | 2007-06-19 |
| 1710196936 | John D Corbitt Jr. | Surgery | 142 John F Kennedy Dr, Lake Worth, FL 33462-1159 | 2007-05-22 |
| 1437145919 | Fred L Simon | Surgery | 4665 S Congress Ave, Suite 100, Lake Worth, FL 33461-4754 | 2005-09-21 |
| Find all providers in LAKE WORTH | ||||
| City | LAKE WORTH |
| Zip Code | 33462 |
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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.