Provider Demographics
NPI:1235456278
Name:FLORIDA KIDNEY INSTITUTE, PA
Entity Type:Organization
Organization Name:FLORIDA KIDNEY INSTITUTE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHO CHUNG HING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-416-7734
Mailing Address - Street 1:1500 E VENICE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 E VENICE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1662
Practice Address - Country:US
Practice Address - Phone:941-416-7734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84851207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty