Kidneyspa Tampa Bay Home LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

KIDNEYSPA TAMPA BAY HOME LLC

Practice address

508 S Habana Ave Ste 270
Tampa, FL 33609-4198

Phone

(305) 548-4000

Fax

(305) 329-2901

NPI assigned

May 10, 2023

Last updated

May 30, 2023By 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

Juan M Cuellar

Title

Ceo

Phone

(305) 548-4000

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Tampa Bay Renal LLC

  • Nephrology Physician
  • Tampa, FL
  • NPI 1609249374

  Member Of

  NPD member

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.

• Chhavi Gupta, MD

  • Nephrology Physician
  • Tampa, FL
  • NPI 1003052945
  NPD (past)

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1952091241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 NW 12TH AVE APT 508",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331282206",
            "telephone_number": "305-548-4000",
            "fax_number": "305-329-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S HABANA AVE STE 270",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094198",
            "telephone_number": "305-548-4000",
            "fax_number": "305-329-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEYSPA TAMPA BAY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "CUELLAR",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-548-4000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morissa Kidd
• Kiddo-Land Therapy, Inc
• Kiddo-Land Therapy, Inc
• Kiddotherapy LLC
• Kidney Doctor, Corp.
• Kids Home Care, Inc.
• Kids Smiles Dental, PLLC
• Kids Smiles Pedo, PLLC
• Kelly Marie Kidwell, DMD
• Kristina Nikole Kidwell

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.