Provider Demographics
NPI:1891003729
Name:KIDNEY SPECIALISTS OF THE PALM BEACHES
Entity Type:Organization
Organization Name:KIDNEY SPECIALISTS OF THE PALM BEACHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNILA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-283-0384
Mailing Address - Street 1:1100 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-4910
Mailing Address - Country:US
Mailing Address - Phone:561-283-0384
Mailing Address - Fax:561-282-3238
Practice Address - Street 1:11301 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE 5A
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8719
Practice Address - Country:US
Practice Address - Phone:561-283-0384
Practice Address - Fax:561-282-3238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94755Medicare PIN