NPIMap

Organization Active NPI

Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Englewood, FL
National Provider Identifier
1295402121
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
FLORIDA KIDNEY PHYSICIANS, LLC
Practice address
1861 Placida Rd Ste 203
Englewood, FL 34223-4949
Phone
(813) 910-0030
Fax
(813) 971-6473
NPI assigned
Aug 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maria Elena Rivera
Title
Credentialing Manager
Phone
(480) 610-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1861 Placida Rd Ste 203
Englewood, FL 34223-4949

Mailing address

1861 Placida Rd Ste 203
Englewood, FL 34223-4949
Phone (813) 910-0030

National Provider Directory

National Provider Directory
Tax ID family
Florida Kidney Physicians LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1861 Placida Rd
Ste 203
Englewood, FL 34223

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1295402121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 PLACIDA RD STE 203",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234949",
            "telephone_number": "813-910-0030",
            "fax_number": "813-971-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 PLACIDA RD STE 203",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234949",
            "telephone_number": "813-910-0030",
            "fax_number": "813-971-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA KIDNEY PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "480-610-6100"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.