Organization Active NPI

Kidney Care Plus Inc

  • Nephrology Physician
  • Pembroke Pines, FL
National Provider Identifier
1881934347
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME105945 Issued in FL
Legal business name
KIDNEY CARE PLUS INC
Practice address
1 SW 129TH Ave Ste 405
Pembroke Pines, FL 33027-1718
Phone
(954) 228-8180
Fax
(954) 228-8183
NPI assigned
Feb 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Dr. Pedro Hernandez Lopez, M.D.NPI 1649498569
Title
Director
Phone
(954) 668-3101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X ME105945 FL Primary

Addresses

Primary practice location

1 SW 129TH Ave Ste 405
Pembroke Pines, FL 33027-1718

Mailing address

4408 SW 195TH Ter
Miramar, FL 33029-6201
Phone (954) 668-3101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130508000205 FL Part B Supplier - Clinic/Group Practice 2264679406 Receives reassigned benefits from 7 practitioners
Practice locations: Hollywood, FL; Pembroke Pines, FL; Miramar, FL

National Provider Directory

National Provider Directory

Locations

777 E 25th St
Ste 201
Hialeah, FL 33013
Phone (305) 696-8802

1871 SW 22nd St
Miami, FL 33145
Phone (305) 856-8060

4805 NW 183rd St
Miami Gardens, FL 33055
Phone (305) 620-9261

2501 SW 160th Ave
Miramar, FL 33027

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1881934347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4408 SW 195TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330296201",
            "telephone_number": "954-668-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SW 129TH AVE STE 405",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271718",
            "telephone_number": "954-228-8180",
            "fax_number": "954-228-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE PLUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ LOPEZ",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-668-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME105945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.