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General NPI Number Information
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NPI Number | 1841572559
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Entity Type | Organization
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Legal Business Name | 21ST CENTURY ONCOLOGY LLC
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 1031 SE 9TH PL UNIT 2
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City | CAPE CORAL
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State | FL
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Zip | 33990-3003
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Country | US
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Telephone | 239-573-8448
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Fax | 239-573-8604
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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Authorized Official
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Title or Position | CEO
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Name | KIM COMMINS
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Credential |
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Telephone | 239-931-7277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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