Organization
21ST CENTURY ONCOLOGY LLC
Active
Parent organization
RADIATION THERAPY SERVICES INC
Other names
Okaloosa-Walton Urology
Organization subpart
Yes
Provider details
NPI number
Legal business name
RADIATION THERAPY SERVICES INC
Authorized official
DIANNA HARRISON (SR. DIRECTOR OF PROVIDER RELATIONS)
(239) 931-7342
Entity
Organization
Contact information
Practice address
131 E REDSTONE AVE, SUITE 102, CRESTVIEW, FL 32539-5326
(850) 682-6333
(850) 682-0865
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
06/15/2010
Last updated
02/03/2025
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