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General NPI Number Information
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NPI Number | 1093524167
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Entity Type | Organization
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Legal Business Name | PROTON FUSION, LLC
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 9961 ESTERO OAKS DR UNIT 101A
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City | FORT MYERS
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State | FL
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Zip | 33967-5453
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Country | US
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Telephone | 239-516-0009
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Fax | 239-266-9769
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Provider Business Mailing Address
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Address Line | PO BOX 96362
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City | CHARLOTTE
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State | NC
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Zip | 28296-6362
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Country | US
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Telephone | 239-416-8101
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Fax | 239-402-8601
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Authorized Official
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Title or Position | CEO
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Name | ARIE P DOSORETZ
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Credential | MD
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Telephone | 215-681-3340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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