Provider Demographics
NPI:1033317433
Name:A UNIQUE KIDNEY CENTER LLC
Entity Type:Organization
Organization Name:A UNIQUE KIDNEY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:GULATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-438-6080
Mailing Address - Street 1:10726 CHARLESTON PL
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4906
Mailing Address - Country:US
Mailing Address - Phone:954-438-6080
Mailing Address - Fax:954-499-5599
Practice Address - Street 1:3105 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33024-2234
Practice Address - Country:US
Practice Address - Phone:954-438-6080
Practice Address - Fax:954-966-3656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, PeritonealGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL682504Medicare Oscar/Certification