Provider Demographics
NPI:1043468754
Name:SPECIALIST IN UROLOGY, PA.
Entity type:Organization
Organization Name:SPECIALIST IN UROLOGY, PA.
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:239-434-6300
Mailing Address - Street 1:990 TAMIAMI TRL N STE 200
Mailing Address - Street 2:
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 1:8340 COLLIER BLVD STE 402
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3626
Practice Address - Country:US
Practice Address - Phone:239-732-1340
Practice Address - Fax:239-732-1243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271381100Medicaid
FLCE1209Medicare PIN
FL1000070004Medicare NSC
FLK1308Medicare PIN