Provider Demographics
NPI:1205933769
Name:NEPHROLOGY ASSOCIATES OF NORTH CENTRAL FLORIDA P A
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF NORTH CENTRAL FLORIDA P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-377-5600
Mailing Address - Street 1:4423 NW 6TH PLACE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6115
Mailing Address - Country:US
Mailing Address - Phone:352-377-5600
Mailing Address - Fax:352-377-0995
Practice Address - Street 1:4423 NW 6TH PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6115
Practice Address - Country:US
Practice Address - Phone:352-377-5600
Practice Address - Fax:352-377-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253258100Medicaid
FL253258101Medicaid
FL72429Medicare ID - Type UnspecifiedMEDICARE GROUP #