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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1659711018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	21ST CENTURY ONCOLOGY LLC

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	:	28930 TRAILS EDGE BLVD
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7582
Country	:	US
Telephone Number	:	239-495-3000
Fax Number	:	239-948-5375

Authorized Official
Title or Position	:	CEO
Name	:	KIM COMMINS
Credential	:
Telephone Number	:	239-931-7277

Provider Enumeration Date	:	07/01/2013
Last Update Date	:	07/12/2019

Similar Medicare Providers

1306209200 — GULFSHORE UROLOGY LLC
Practice Location Address:

28930 TRAILS EDGE BLVD , SUITE 200
BONITA SPRINGS, FL
34134-7582

Practice Phone: 239-333-3200
Practice Fax: 239-992-5785

1639650161 — TRAILS EDGE SURGERY CENTER, LLC
Practice Location Address:

28930 TRAILS EDGE BLVD
BONITA SPRINGS, FL
34134-7582

Practice Phone: 239-333-3200
Practice Fax:

1740134493 — RYAN SHOWALTER
Practice Location Address:

8540 SCARBOROUGH DR STE 350
COLORADO SPRINGS, CO
80920-7582

Practice Phone: 817-964-2211
Practice Fax:

1871837138 — JASON LYNN WILKINSON DPT
Practice Location Address:

8540 SCARBOROUGH DR STE 350
COLORADO SPRINGS, CO
80920-7582

Practice Phone: 719-590-7777
Practice Fax:

1437157724 — GUILLERMO BOHM MD
Practice Location Address:

4061 BONITA BEACH RD STE 101
BONITA SPRINGS, FL
34134-4073

Practice Phone: 239-301-0105
Practice Fax: 239-301-0110

1336147636 — RONICA M KLUGE MD
Practice Location Address:

24600 S TAMIAMI TRL , SUITE 400
BONITA SPRINGS, FL
34134-7022

Practice Phone: 239-948-3761
Practice Fax: 239-931-3454

Directions to “21ST CENTURY ONCOLOGY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.