Florida Physician Specialists LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

FLORIDA PHYSICIAN SPECIALISTS LLC

Doing business as

Advanced Prostate Cancer Institute

Practice address

1860 Town Hall Cir
Fleming Island, FL 32003-4331

Phone

(904) 520-6800

Fax

(904) 520-6801

NPI assigned

Aug 23, 2018

Organization subpart

Yes

Parent organization

FLORIDA PHYSICIAN SPECIALISTS LLCAs reported in NPPES

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

Authorized official

Name

Meaghan Colleen Lutz

Title

Cfo

Phone

(904) 520-6800

Specialties & licenses 2

Addresses

Other names 1

• Advanced Prostate Cancer Institute Doing business as

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

CLIA laboratory certificates

Tax ID family

Florida Physician Specialists LLC2 organizations share this tax ID, including this one

Part of

Florida Physician Specialists LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Florida Physician Specialists LLC

  dba Urology Associates of Northeast Florida

  • Urology Physician
  • Orange Park, FL
  • NPI 1932444254
  NPD tax ID

Locations

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1932680469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 A C SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-520-6800",
            "fax_number": "904-520-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN HALL CIR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034331",
            "telephone_number": "904-520-6800",
            "fax_number": "904-520-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PHYSICIAN SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA PHYSICIAN SPECIALISTS LLC",
        "enumeration_date": "2018-08-23",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "LUTZ",
        "authorized_official_first_name": "MEAGHAN",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "904-520-6800"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Prostate Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Prostate Cancer Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fleming Island Plastic Surgery LLC
• Fleming Island Plastic Surgery LLC
• Fleming Island Vision Center, Inc. (Pearle Vision of Fleming Island)
• Florida Cancer Specialists & Research Institute, LLC (Florida Cancer Specialists)
• Florida Department of Health
• Florida Woman Care, LLC
• Florida Woman Care,LLC
• Karma B Flotkoetter, BCBA
• Elizabeth Marie Fogle
• Haley Ford, PA-C

• Specialist in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.