NPIMap

Organization Active NPI

Comprehensive Kidney Care

  • Nephrology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1619547262
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
COMPREHENSIVE KIDNEY CARE
Practice address
400 SE 12TH St Ste C
Fort Lauderdale, FL 33316-1937
Phone
(305) 479-4638
NPI assigned
Jun 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Marjan Vandevar, DO
Title
President
Phone
(305) 479-4638

Specialties & licenses 1

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

Addresses

Primary practice location

400 SE 12TH St Ste C
Fort Lauderdale, FL 33316-1937

Mailing address

1663 SW 132ND Way
Davie, FL 33325-5734
Phone (305) 479-4638

Other practice location 1

315 SE 13th St
Ft Lauderdale, FL 33316-1923
Phone (305) 479-4638

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mvandevardo@gmail.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

400 SE 12th St
Ste C
Ft Lauderdale, FL 33316
Phone (304) 479-4638

315 SE 13th St
Ft Lauderdale, FL 33316
Phone (305) 479-4638

Networks

  • HealthSun Health Plans Network

NPI Registry JSON

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

{
    "created_epoch": "1624752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1619547262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 SW 132ND WAY",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333255734",
            "telephone_number": "305-479-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SE 12TH ST STE C",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161937",
            "telephone_number": "305-479-4638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 SE 13th St",
            "address_purpose": "LOCATION",
            "city": "Ft Lauderdale",
            "state": "FL",
            "postal_code": "333161923",
            "country_code": "US",
            "telephone_number": "305-479-4638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMPREHENSIVE KIDNEY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-27",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "VANDEVAR",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-479-4638",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mvandevardo@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 SE 12th St Ste C",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333161937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.