Gulfstream Urology, PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME87076 Issued in FL

Legal business name

GULFSTREAM UROLOGY, PA

Practice address

14320 Metropolis Ave Ste 1
Fort Myers, FL 33912-4539

Phone

(239) 277-5770

Fax

(239) 985-1911

NPI assigned

Feb 12, 2015

Last updated

Feb 11, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Meir Daller, MDNPI 1386656528

Title

Owner

Phone

(239) 980-2302

Specialties & licenses 1

Addresses

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12899/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Meir Daller, M.D.

  • Urology Physician
  • Fort Myers, FL
  • NPI 1386656528
  Authorized official Same address or phone
• Morgan Brianna Kidwell, PA

  • Physician Assistant
  • Lake Wales, FL
  • NPI 1508529835
  NPD
• Karson Nicole Hoagland, PA

  • Physician Assistant
  • San Francisco, CA
  • NPI 1336818517
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1255722203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8931 COLONIAL CENTER DR",
            "address_2": "SUITE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14320 METROPOLIS AVE STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124539",
            "telephone_number": "239-277-5770",
            "fax_number": "239-985-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFSTREAM UROLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "DALLER",
        "authorized_official_first_name": "MEIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-980-2302",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME87076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mel@teamdaller.com",
            "affiliation": "N",
            "endpointDescription": "practice administrator email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14320 Metropolis Ave Ste 1",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339124539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gulfshore Behavioral Health
• Gulfshore Dermatology, P.a.
• Gulfshore Spinal Care, LLC (Gulfshore Spinal Care)
• Gulfside Center for Psychological Services
• Gulfside Healthcare Inc
• Stephanie Gulik, RSCWI
• Christine Gulotta
• Alexander Gumiroff, MD
• Sharon Gunsett, D.D.S.
• Raina Sushil Gupta, MD

• Urology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.