Florida Kidney Physicians, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

FLORIDA KIDNEY PHYSICIANS, LLC

Practice address

18669 Tamiami Trail
North Port, FL 34287

Phone

(941) 505-8720

Fax

(855) 793-3651

NPI assigned

Aug 17, 2021

Organization subpart

No

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

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Florida Kidney Physicians , LLC

  • Nephrology Physician
  • Melbourne, FL
  • NPI 1205506722

  O20161228000460

  Same enrollment
• Florida Kidney Physicians , LLC

  • Nephrology Physician
  • Melbourne, FL
  • NPI 1346910866

  O20161228000460

  Same enrollment
• Florida Kidney Physicians , LLC

  • Nephrology Physician
  • Palm Bay, FL
  • NPI 1548930068

  O20161228000460

  Same enrollment
• Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Temple Terrace, FL
  • NPI 1760831564

  O20161228000460

  Same enrollment

Practitioners 1

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

• Harol Valenzuela, M.D.

  • Nephrology Physician
  • Englewood, NJ
  • NPI 1386030716
  NPD

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1558037028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18669 TAMIAMI TRAIL",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34287",
            "telephone_number": "941-505-8720",
            "fax_number": "855-793-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18669 TAMIAMI TRAIL",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34287",
            "telephone_number": "941-505-8720",
            "fax_number": "855-793-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA KIDNEY PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-07-22",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milena Flores Garcia
• Jennifer Flores Pena, DDS
• Florida Autism Center
• Florida Cancer Specialists & Research Institute, LLC
• Florida Department of Health
• Florida Medical Specialists, LLC
• Florida Physical Therapy Specialists PA
• Florida Telehealth LLC
• Florida Woman Care, LLC
• Stephanie Folsom

• Nephrology Physician in North Port, FL
• Providers in North Port, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.