NPIMap

Organization Active NPI

Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Jacksonville, FL
National Provider Identifier
1619540440
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
FLORIDA KIDNEY PHYSICIANS, LLC
Practice address
1201 Monument Rd Ste 301
Jacksonville, FL 32225-6494
Phone
(904) 388-2678
Fax
(904) 388-6776
NPI assigned
Jul 20, 2021
Last updated
Jul 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

1201 Monument Rd Ste 301
Jacksonville, FL 32225-6494

Mailing address

1201 Monument Rd Ste 301
Jacksonville, FL 32225-6494
Phone (904) 388-2678

National Provider Directory

National Provider Directory
Tax ID family
Florida Kidney Physicians12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1619540440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MONUMENT RD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256494",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MONUMENT RD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256494",
            "telephone_number": "904-388-2678",
            "fax_number": "904-388-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA KIDNEY PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "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": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.