Provider Demographics
NPI:1881013746
Name:RENAL GROUP OF SOUTH FLORIDA, INC.
Entity Type:Organization
Organization Name:RENAL GROUP OF SOUTH FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CRISSY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-435-8592
Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1015
Mailing Address - Country:US
Mailing Address - Phone:954-435-5828
Mailing Address - Fax:954-435-8451
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:SUITE 104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1015
Practice Address - Country:US
Practice Address - Phone:954-435-5828
Practice Address - Fax:954-435-8451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty