Provider Demographics
NPI:1366006967
Name:FLORIDA NEPHROLOGY HYPERTENSION & RENAL TRANSPLANTATION, LLC
Entity Type:Organization
Organization Name:FLORIDA NEPHROLOGY HYPERTENSION & RENAL TRANSPLANTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IJLAL
Authorized Official - Middle Name:
Authorized Official - Last Name:UDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-288-8750
Mailing Address - Street 1:5745 CANTON CV STE 121
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5012
Mailing Address - Country:US
Mailing Address - Phone:407-288-8750
Mailing Address - Fax:407-412-7387
Practice Address - Street 1:5745 CANTON CV STE 121
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5012
Practice Address - Country:US
Practice Address - Phone:407-288-8750
Practice Address - Fax:407-412-7387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty