Organization · NPI-2

21st Centrury Oncology LLC

Urology · North Fort Myers, FL

NPI number1255574190
StatusActive
Last updated in NPPESJul 12, 2019

Details

NPI
1255574190
Entity type
Organization (NPI-2)
Legal business name
21st Centrury Oncology LLC
Organization subpart
Yes
Enumeration date
Apr 8, 2009
Last updated
Jul 12, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208800000X Urology––Yes

Other names

  • Premier Urology (Doing Business As)

Practice location

18900 N Tamiami Trl
Suite A12
North Fort Myers, FL 33903-7312

Phone 239-931-7342 · Fax 239-931-7385

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412

Phone 239-931-7342 · Fax 239-931-7385

Authorized official

Kim Commins
Ceo
2399317277

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