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Organization
PENSACOLA NEPHROLOGY, PA
Active
Organization
PENSACOLA NEPHROLOGY, PA
Active
Other names
Renalus Center for Kidney Care
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DANSBY (CFO)
(850) 444-4700
Entity
Organization
Contact information
Practice address
1619 CREIGHTON RD STE 1, PENSACOLA, FL 32504-7152
(850) 444-4700
(850) 434-8144
Mailing address
PO BOX 11037, PENSACOLA, FL 32524-1037
(850) 444-4700
(850) 444-7497
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256870500
—
FL
05
—
256870509
—
FL
05
—
256870510
—
FL
05
—
256870512
—
FL
05
—
256870513
—
FL
01
—
CF9776
RRB PTAN
FL
01
—
CF9777
RRB PTAN
AL
Enumeration date
06/01/2005
Last updated
02/19/2025
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