Specialists in Urology Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1177 Issued in FL

Legal business name

SPECIALISTS IN UROLOGY SURGERY CENTER, LLC

Practice address

28930 Trails Edge Boulevard
Bonita Springs, FL 34134

Phone

(239) 231-7041

Fax

(844) 857-1822

NPI assigned

Jul 25, 2006

Organization subpart

Yes

Parent organization

SPECIALISTS IN UROLOGY SURGERY CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Lea Harbor

Title

Officer

Phone

(205) 545-2572

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunergy Outpatient Surgery Center-Bonita Springs Doing business as

Part of

Specialists in Urology Surgery Center LLC

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael F D'Angelo, M.D.

  • Urology Physician
  • Ocoee, FL
  • NPI 1114969235
  NPD (past)
• Rolando Rivera, M.D.

  • Urology Physician
  • Naples, FL
  • NPI 1295786093
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1992728810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28930 TRAILS EDGE BOULEVARD",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "34134",
            "telephone_number": "239-231-7041",
            "fax_number": "844-857-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28930 TRAILS EDGE BOULEVARD",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "34134",
            "telephone_number": "239-231-7041",
            "fax_number": "844-857-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALISTS IN UROLOGY SURGERY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALISTS IN UROLOGY SURGERY CENTER, LLC",
        "enumeration_date": "2006-07-25",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "HARBOR",
        "authorized_official_first_name": "LEA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "205-545-2572",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076522800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunergy Outpatient Surgery Center-Bonita Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.