21st Century Oncology LLC
Urology in Fort Walton Beach, FL. Organization (NPI-2).
NPI number1306234174
StatusActive
Last updated in NPPESJul 12, 2019
Details
- NPI
- 1306234174
- Entity type
- Organization (NPI-2)
- Legal business name
- 21st Century Oncology LLC
- Organization subpart
- Yes
- Enumeration date
- Jan 2, 2015
- Last updated
- Jul 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | – | – | Yes |
Other names
- Anthony N Avallone MD (Doing Business As)
Practice location
914b Mar Walt DrFort Walton Beach, FL 32547-6706
Phone 850-226-6572 · Fax 850-862-8564
Mailing address
2234 Colonial BlvdFort Myers, FL 33907-1412
Phone 239-931-7342 · Fax 239-931-7385
Authorized official
Kim Commins
Ceo
2399317277
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