Provider Demographics
NPI:1346910866
Name:FLORIDA KIDNEY PHYSICIANS , LLC
Entity Type:Organization
Organization Name:FLORIDA KIDNEY PHYSICIANS , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:JULIAN
Authorized Official - Last Name:ARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-610-6158
Mailing Address - Street 1:14 SUNTREE PL STE 104
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7605
Mailing Address - Country:US
Mailing Address - Phone:321-768-3655
Mailing Address - Fax:321-831-3024
Practice Address - Street 1:14 SUNTREE PL STE 104
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7605
Practice Address - Country:US
Practice Address - Phone:321-768-3655
Practice Address - Fax:321-831-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty