Provider Demographics
NPI:1184644908
Name:SPECIALISTS IN UROLOGY
Entity Type:Organization
Organization Name:SPECIALISTS IN UROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGLESTHALER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-495-3000
Mailing Address - Street 1:990 TAMIAMI TRL N
Mailing Address - Street 2:200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5403
Mailing Address - Country:US
Mailing Address - Phone:239-434-6300
Mailing Address - Fax:239-434-7174
Practice Address - Street 1:28930 TRAILS EDGE BLVD.
Practice Address - Street 2:200
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134
Practice Address - Country:US
Practice Address - Phone:239-495-3000
Practice Address - Fax:239-948-5375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271381102Medicaid
FLCE1209Medicare PIN
FL1000070004Medicare NSC
FL271381102Medicaid