Provider Demographics
NPI:1225435258
Name:ATLANTIS RENAL NETWORK, INC.
Entity Type:Organization
Organization Name:ATLANTIS RENAL NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-414-9291
Mailing Address - Street 1:10050 NW 44TH TER
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3347
Mailing Address - Country:US
Mailing Address - Phone:786-414-9291
Mailing Address - Fax:305-330-9458
Practice Address - Street 1:10050 NW 44TH TER
Practice Address - Street 2:SUITE 103
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3347
Practice Address - Country:US
Practice Address - Phone:786-414-9291
Practice Address - Fax:305-330-9458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment