Organization Active NPI

Florida Nephrology Hypertension & Renal Transplantation, LLC

  • Nephrology Physician
  • Winter Park, FL
National Provider Identifier
1366006967
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
FLORIDA NEPHROLOGY HYPERTENSION & RENAL TRANSPLANTATION, LLC
Practice address
4355 Bear Gully Rd Ste 1024
Winter Park, FL 32792-9422
Phone
(407) 647-2550
Fax
(407) 647-0616
NPI assigned
Apr 29, 2019
Last updated
Jan 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
Ijlal Uddin, MDNPI 1760652879
Title
Owner/ Operator
Phone
(407) 647-2550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary
Medical Specialty Clinic/Center 261QM2500X NU

Addresses

Primary practice location

4355 Bear Gully Rd Ste 1024
Winter Park, FL 32792-9422

Mailing address

5745 Canton CV Ste 121
Winter Springs, FL 32708-5012
Phone (407) 288-8750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191022000557 FL Part B Supplier - Clinic/Group Practice 4183956345 Receives reassigned benefits from 2 practitioners
Practice locations: Casselberry, FL; Orlando, FL; Winter Park, FL

National Provider Directory

National Provider Directory

Locations

5745 Canton Cv
Ste 121
Winter Springs, FL 32708
Phone (407) 545-6232

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1366006967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5745 CANTON CV STE 121",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085012",
            "telephone_number": "407-288-8750",
            "fax_number": "407-412-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 BEAR GULLY RD STE 1024",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327929422",
            "telephone_number": "407-647-2550",
            "fax_number": "407-647-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA NEPHROLOGY HYPERTENSION & RENAL TRANSPLANTATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-29",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "UDDIN",
        "authorized_official_first_name": "IJLAL",
        "authorized_official_title_or_position": "OWNER/ OPERATOR",
        "authorized_official_telephone_number": "407-647-2550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.