21St Century Oncology LLC
Organization Active NPI Surgery Physician · Hollywood, FL
NPI 1891166971 · NPPES record last updated Jul 12, 2019
Key facts
- NPI
- 1891166971
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- 21ST CENTURY ONCOLOGY LLC
- Practice address
- 4000 Hollywood Blvd
Presidential Circle - Suite 160 North
Hollywood, FL 33021-6751 - Phone
- (954) 986-6366
- Fax
- (954) 986-4355
- NPI assigned
- Oct 14, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- 21ST CENTURY ONCOLOGY INC
Authorized official
- Name
- Kim Commins
- Title
- Ceo
- Phone
- (239) 931-7277
Parent organization (reported in NPPES) 1
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
4000 Hollywood Blvd
Presidential Circle - Suite 160 North
Hollywood, FL 33021-6751
Mailing address
2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342
Other names
- The Donoway Center for Cancer Treatment and Prevention
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All providers in Hollywood, FL · Surgery Physician in Florida
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.