Provider Demographics
NPI:1801960265
Name:THE KIDNEY & HYPERTENS CTR PLC
Entity type:Organization
Organization Name:THE KIDNEY & HYPERTENS CTR PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:NAVANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-214-0028
Mailing Address - Street 1:9063 POINT CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5475
Mailing Address - Country:US
Mailing Address - Phone:321-214-0028
Mailing Address - Fax:
Practice Address - Street 1:306 S 10TH ST
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-5619
Practice Address - Country:US
Practice Address - Phone:321-214-0028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6619Medicare PIN