Healthcare Provider Details

I. General information

NPI: 1407109317
Provider Name (Legal Business Name): SPECIALISTS IN UROLOGY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 SIERRA MEADOWS BLVD
NAPLES FL
34113-7328
US

IV. Provider business mailing address

955 10TH AVE N
NAPLES FL
34102-5452
US

V. Phone/Fax

Practice location:
  • Phone: 239-434-6300
  • Fax: 238-325-2285
Mailing address:
  • Phone: 239-434-6300
  • Fax: 239-325-2285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM MATHEW FIGLESTHALER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 239-434-6300