Provider Demographics
NPI:1982141412
Name:UNIVERSAL KIDNEY CARE LLC
Entity Type:Organization
Organization Name:UNIVERSAL KIDNEY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAQAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-635-9620
Mailing Address - Street 1:10175 FORTUNE PKWY UNIT 302
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6749
Mailing Address - Country:US
Mailing Address - Phone:571-635-9620
Mailing Address - Fax:866-339-2911
Practice Address - Street 1:4600 MIDDLETON PARK CIR E APT D250
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-4684
Practice Address - Country:US
Practice Address - Phone:571-635-9620
Practice Address - Fax:866-339-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty