NPIMap

Organization Active NPI

Specialists in Urology Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1912209800
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1334 Issued in FL
Legal business name
SPECIALISTS IN UROLOGY SURGERY CENTER LLC
Practice address
4571 Colonial Blvd
Suite 200
Fort Myers, FL 33966
Phone
(239) 434-6300
Fax
(239) 325-2285
NPI assigned
Nov 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Ms. Jacqueline Lucia
Title
Chief Administrative Officer
Phone
(239) 963-7365

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 1334 FL Primary

Addresses

Primary practice location

4571 Colonial Blvd
Suite 200
Fort Myers, FL 33966

Mailing address

4571 Colonial Blvd Ste 200
Fort Myers, FL 33966-1156
Phone (239) 963-7365

Other names 1

  • Specialists In Urology Surgery Center Fort Myers Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1290729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1912209800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4571 COLONIAL BLVD STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661156",
            "telephone_number": "239-963-7365",
            "fax_number": "239-322-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4571 COLONIAL BLVD",
            "address_2": "SUITE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33966",
            "telephone_number": "239-434-6300",
            "fax_number": "239-325-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALISTS IN UROLOGY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-26",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "LUCIA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "239-963-7365",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialists In Urology Surgery Center Fort Myers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Specialists In Urology Surgery Center Fort Myers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.