Provider Demographics
NPI:1952557860
Name:FLORIDA KIDNEY AND HYPERTENSION SPECIALISTS PA
Entity type:Organization
Organization Name:FLORIDA KIDNEY AND HYPERTENSION SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-668-4650
Mailing Address - Street 1:2877 WELLNESS AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8396
Mailing Address - Country:US
Mailing Address - Phone:386-668-4650
Mailing Address - Fax:386-668-4649
Practice Address - Street 1:2877 WELLNESS AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8396
Practice Address - Country:US
Practice Address - Phone:386-668-4650
Practice Address - Fax:386-668-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86550174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001026300Medicaid
FLP77565Medicare UPIN
FL001026300Medicaid
FLH29762Medicare UPIN
FLP24131Medicare UPIN