Provider Demographics
NPI:1346297173
Name:NEPHROLOGY ASSOCIATES OF CENTRAL FLORIDA, P.A.
Entity Type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF CENTRAL FLORIDA, P.A.
Other - Org Name:METZGER, PINS AND WARREN, M.D., P.A.
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:AYCRIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-894-4693
Mailing Address - Street 1:807 S ORLANDO AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4870
Mailing Address - Country:US
Mailing Address - Phone:407-894-4693
Mailing Address - Fax:407-539-0469
Practice Address - Street 1:807 S ORLANDO AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4870
Practice Address - Country:US
Practice Address - Phone:407-894-4693
Practice Address - Fax:407-539-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1574OtherAVMED
FLCF6503OtherRAILROAD MEDICARE
FL202226500Medicaid
FL5915615714OtherEIN
FL5915615714OtherEIN