MEDICARE: ARIZONA RADIATION THERAPY MANAGEMENT SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

General Provider Information

NPI Number	:	1124363064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA RADIATION THERAPY MANAGEMENT SERVICES INC

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	2525 E ARIZONA BILTMORE CIR
Second Line	:	SUITE C 236
City	:	PHOENIX
State	:	AZ
Zip	:	85016-2146
Country	:	US
Telephone Number	:	602-426-9772
Fax Number	:	602-426-9775

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	DANIEL E. DOSORETZ
Credential	:	MD
Telephone Number	:	239-931-7277

Provider Enumeration Date	:	12/04/2012
Last Update Date	:	12/04/2012

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