Kidney Doctor, Corp.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

KIDNEY DOCTOR, CORP.

Practice address

4710 N Habana Ave Ste 300
Tampa, FL 33614-7151

Phone

(813) 873-1016

Fax

(813) 874-2813

NPI assigned

Dec 4, 2017

Last updated

Dec 4, 2017By 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

Otto Ostolaza-Garcia, MDNPI 1821269051

Title

Owner/President

Phone

(813) 873-1016

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Otto Ostolaza-Garcia, M.D.

  • Nephrology Physician
  • Tampa, FL
  • NPI 1821269051
  Authorized official Same address or phone

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1871008508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N 12TH ST UNIT 1424",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023674",
            "telephone_number": "407-718-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147151",
            "telephone_number": "813-873-1016",
            "fax_number": "813-874-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY DOCTOR, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "OSTOLAZA-GARCIA",
        "authorized_official_first_name": "OTTO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-873-1016",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010280100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda K Kidd, MS, CCC-SLP
• Morissa Kidd
• Kiddo-Land Therapy, Inc
• Kiddo-Land Therapy, Inc
• Kiddotherapy LLC
• Kidneyspa Tampa Bay Home LLC
• Kids Home Care, Inc.
• Kids Smiles Dental, PLLC
• Kids Smiles Pedo, PLLC
• Kelly Marie Kidwell, DMD

• Nephrology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.