Provider Demographics
NPI:1811943434
Name:NEPHROLOGY ASSOCIATES OF SOUTH MIAMI PA
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF SOUTH MIAMI PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUSSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-273-9377
Mailing Address - Street 1:9193 SUNSET DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3487
Mailing Address - Country:US
Mailing Address - Phone:305-273-9377
Mailing Address - Fax:305-273-9388
Practice Address - Street 1:9193 SUNSET DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3487
Practice Address - Country:US
Practice Address - Phone:305-273-9377
Practice Address - Fax:305-273-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL92155OtherBCBS
FL063809900OtherPSN
FL43805OtherBCBS
FL64370OtherBCBS
FL78626OtherBCBS
FLP00088820OtherRAILROAD MEDICARE
FLP00241477OtherRAILROAD MEDICARE
FL00859OtherBCBS
FLP00222398OtherRAILROAD MEDICARE
FLP00095463OtherRAILROAD MEDICARE
FL052511100OtherPSN
FL05712OtherBCBS
FL91824OtherBCBS
FL052511100OtherPSN
FL063809900OtherPSN
FL00590Medicare UPIN
FLP00095463OtherRAILROAD MEDICARE
FLP00088820OtherRAILROAD MEDICARE
FL64370OtherBCBS
FL43805OtherBCBS
FL00859OtherBCBS