Organization Active NPI

Nephrology Specialists of Florida, LLC.

  • Nephrology Physician
  • Coral Gables, FL
National Provider Identifier
1477083269
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY SPECIALISTS OF FLORIDA, LLC.
Practice address
747 Ponce de Leon Blvd Ste 605
Coral Gables, FL 33134-2074
Phone
(305) 407-9900
NPI assigned
Jun 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Jose M Cardona-Guzman, M.D.NPI 1861709230
Title
Owner
Phone
(305) 407-9900

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

747 Ponce de Leon Blvd Ste 605
Coral Gables, FL 33134-2074

Mailing address

PO Box 652256
Miami, FL 33265-2256
Phone (305) 407-9900

Other practice location 1

12905 SW 42nd Street
Suite 213
Miami, FL 33175-2912
Phone (305) 705-5651

Other identifiers 2

IdentifierTypeStateIssuer
GI3222ZOtherFLMEDICARE
005961600MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180223001592 FL Part B Supplier - Clinic/Group Practice 5294096756 Receives reassigned benefits from 5 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1477083269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 652256",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332652256",
            "telephone_number": "305-407-9900",
            "fax_number": "888-981-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 PONCE DE LEON BLVD STE 605",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342074",
            "telephone_number": "305-407-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12905 SW 42nd Street",
            "address_2": "Suite 213",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331752912",
            "country_code": "US",
            "telephone_number": "305-705-5651",
            "fax_number": "888-981-2863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEPHROLOGY SPECIALISTS OF FLORIDA, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CARDONA-GUZMAN",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-407-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GI3222Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005961600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.