Provider Demographics
NPI:1487005195
Name:MIAMI RENAL INSTITUTE LLC
Entity Type:Organization
Organization Name:MIAMI RENAL INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-615-1514
Mailing Address - Street 1:2040 NE 163RD ST STE 204
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4953
Mailing Address - Country:US
Mailing Address - Phone:305-615-1514
Mailing Address - Fax:305-501-4731
Practice Address - Street 1:2040 NE 163RD ST STE 204
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4953
Practice Address - Country:US
Practice Address - Phone:305-615-1514
Practice Address - Fax:305-501-4731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103495207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000770700Medicaid