Provider Demographics
NPI:1396894952
Name:MIAMI KIDNEY GROUP PLLC
Entity type:Organization
Organization Name:MIAMI KIDNEY GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESQUENAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-662-3984
Mailing Address - Street 1:7900 SW 57TH AVE
Mailing Address - Street 2:#21
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5522
Mailing Address - Country:US
Mailing Address - Phone:305-662-3984
Mailing Address - Fax:305-661-1129
Practice Address - Street 1:7900 SW 57TH AVE
Practice Address - Street 2:#21
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5522
Practice Address - Country:US
Practice Address - Phone:305-662-3984
Practice Address - Fax:305-661-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374286500Medicaid