21St Century Oncology LLC
Organization Active NPI Urology Physician · Naples, FL
NPI 1669701918 · NPPES record last updated Jul 12, 2019
Key facts
- NPI
- 1669701918
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- Legal business name
- 21ST CENTURY ONCOLOGY LLC
- Practice address
- 1044 Goodlette Rd N
Naples, FL 34102-5449 - Phone
- (239) 261-5400
- Fax
- (239) 261-4387
- NPI assigned
- Dec 16, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- RADIATION THERAPY SERVICES INC
Authorized official
- Name
- Kim Commins
- Title
- Ceo
- Phone
- (239) 931-7277
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040204000663 | FL | Part B Supplier - Clinic/Group Practice | 9830082882 |
Receives reassigned benefits from 314 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Genesiscare USA of Florida LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | Yes |
Addresses
Primary practice location
1044 Goodlette Rd N
Naples, FL 34102-5449
Mailing address
2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CE7138 | Other | FL | RAILROAD MEDICARE |
Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.