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NPI Code Detail

MEDICARE: 21ST CENTURY ONCOLOGY LLC

MEDICARE: 21ST CENTURY ONCOLOGY LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1316426281
Entity Type Code : Organization
Provider Name (Legal Business Name) : 21ST CENTURY ONCOLOGY LLC
Provider Business Mailing Address
First Line : 2160 COLONIAL BLVD
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1410
Country : US
Telephone Number : 239-931-7342
Fax Number : 239-931-7385
Provider Business Practice Location Address
First Line : 1200 E BROWARD BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-2134
Country : US
Telephone Number : 954-463-6408
Fax Number : 954-463-1858
Authorized Official
Title or Position : CEO
Name : KIMBERY COMMINS-TZOUMAKAS
Credential :
Telephone Number : 239-931-7277
Provider Enumeration Date : 08/10/2018
Last Update Date : 10/24/2018

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Directions to “21ST CENTURY ONCOLOGY LLC ” Practice Location

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