Healthcare Provider Details

I. General information

NPI: 1093748907
Provider Name (Legal Business Name): SPECIALISTS IN UROLOGY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 TAMIAMI TRL N SUITE 100
NAPLES FL
34102-5403
US

IV. Provider business mailing address

990 TAMIAMI TRAIL NORTH SUITE 100
NAPLES FL
34102-5403
US

V. Phone/Fax

Practice location:
  • Phone: 239-434-6300
  • Fax: 239-434-8398
Mailing address:
  • Phone: 239-434-6300
  • Fax: 239-434-8398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number1177
License Number StateFL

VIII. Authorized Official

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