Infigo Dialysis LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

INFIGO DIALYSIS LLC

Practice address

1403 Medical Plaza Dr Ste 207
Sanford, FL 32771-1047

Phone

(321) 364-0728

Fax

(321) 364-0729

NPI assigned

Apr 12, 2022

Last updated

Apr 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sayed Mohammed Husain, MD

Title

MGR

Phone

(321) 364-0728

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650499200000",
    "number": "1598407207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR STE 207",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711047",
            "telephone_number": "321-364-0728",
            "fax_number": "321-364-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR STE 207",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711047",
            "telephone_number": "321-364-0728",
            "fax_number": "321-364-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFIGO DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A",
        "authorized_official_last_name": "HUSAIN",
        "authorized_official_first_name": "SAYED",
        "authorized_official_middle_name": "MOHAMMED",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "321-364-0728",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ME128664",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "ME128664",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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