Healthcare Provider Details
I. General information
NPI: 1548513740
Provider Name (Legal Business Name): SPECIALISTS IN UROLOGY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2012
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
955 10TH AVE N
NAPLES FL
34102-5452
US
IV. Provider business mailing address
955 10TH AVE N
NAPLES FL
34102-5452
US
V. Phone/Fax
- Phone: 239-434-6300
- Fax: 239-325-2285
- Phone: 239-434-6300
- Fax: 239-325-2285
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
MATHEW
FIGLESTHALER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 239-434-6300