Provider Demographics
NPI:1861038820
Name:ACE KIDNEY LLC
Entity Type:Organization
Organization Name:ACE KIDNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANGHAMITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SADHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-205-8507
Mailing Address - Street 1:2582 MAGUIRE RD UNIT 249
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4749
Mailing Address - Country:US
Mailing Address - Phone:407-205-8507
Mailing Address - Fax:
Practice Address - Street 1:9100 CONROY WINDERMERE RD STE 200
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-8431
Practice Address - Country:US
Practice Address - Phone:407-205-8507
Practice Address - Fax:615-235-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty