Healthcare Provider Details

I. General information

NPI: 1093524167
Provider Name (Legal Business Name): PROTON FUSION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9961 ESTERO OAKS DR UNIT 101A
FORT MYERS FL
33967-5453
US

IV. Provider business mailing address

PO BOX 96362
CHARLOTTE NC
28296-6362
US

V. Phone/Fax

Practice location:
  • Phone: 239-516-0009
  • Fax: 239-266-9769
Mailing address:
  • Phone: 239-416-8101
  • Fax: 239-402-8601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARIE P DOSORETZ
Title or Position: CEO
Credential: MD
Phone: 215-681-3340