Provider Demographics
NPI:1003683020
Name:SOUTH FLORIDA RENAL CARE, LLC.
Entity Type:Organization
Organization Name:SOUTH FLORIDA RENAL CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-606-0337
Mailing Address - Street 1:1960 TATNALL SQ APT 205
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-8111
Mailing Address - Country:US
Mailing Address - Phone:772-559-1309
Mailing Address - Fax:
Practice Address - Street 1:1960 TATNALL SQ APT 205
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-8111
Practice Address - Country:US
Practice Address - Phone:772-559-1309
Practice Address - Fax:305-698-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty