South Florida Kidney Care LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

SOUTH FLORIDA KIDNEY CARE LLC

Practice address

3854 Sheridan St Ste a
Hollywood, FL 33021-3630

Phone

(954) 966-3018

Fax

(954) 966-5249

NPI assigned

Apr 22, 2014

Organization subpart

No

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

Authorized official

Name

Ryan Valle

Title

President

Phone

(781) 699-9362

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Comprehensive Kidney Care of South Florida Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• HealthSun Health Plans Network

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Venkat Pradeepkumar Amara, M.D.

  • Nephrology Physician
  • Hollywood, FL
  • NPI 1972808483
  Medicare reassignment Care Compare group NPD
• Elie Ciril, M.D.

  • Nephrology Physician
  • Hollywood, FL
  • NPI 1477854891
  Medicare reassignment Care Compare group NPD
• Juanita Christene Grillo, APRN

  • Nurse Practitioner
  • Hollywood, FL
  • NPI 1770356826
  Medicare reassignment Care Compare group NPD
• Carmen Andreea Hoisan, APRN, FNP-BC, FNP-C

  • Nurse Practitioner
  • Hollywood, FL
  • NPI 1023902517
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1316367998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3854 SHERIDAN ST STE A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213630",
            "telephone_number": "954-966-3018",
            "fax_number": "954-966-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3854 SHERIDAN ST STE A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213630",
            "telephone_number": "954-966-3018",
            "fax_number": "954-966-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA KIDNEY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-22",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "VALLE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-699-9362"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012854700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Kidney Care of South Florida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Comprehensive Kidney Care of South Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Florida Cardiothoracic and Vascular Surgery PL
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• South Florida Family Medical Center, LLC.
• South Florida Geriatrics and Palliative Medicine PA
• South Florida Heart Center, P.L.
• South Florida Medical Assoc PA
• South Florida Medical Clinics Association Inc
• South Florida Medical Practice LLC
• South Florida Nephrology PA
• South Florida Pediatric Homecare Inc.

• Nephrology Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.