Healthcare Provider Details
I. General information
NPI: 1952072852
Provider Name (Legal Business Name): INSPIRE ONCOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15465 TAMIAMI TRL N
NAPLES FL
34110-6216
US
IV. Provider business mailing address
8625 COLLIER BLVD UNIT 102
NAPLES FL
34114-3636
US
V. Phone/Fax
- Phone: 239-429-0200
- Fax:
- Phone: 239-429-0100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
EDWIN
BUNNELL
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 239-470-4048