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Organization
KIDNEY DISEASE CONSULTANTS OF BRADENTON PA
Active
Organization
KIDNEY DISEASE CONSULTANTS OF BRADENTON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS NEWBY BRAXTAN III M.D. (PRESIDENT)
(941) 744-0024
Entity
Organization
Contact information
Practice address
508 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 744-0024
(941) 746-1048
Mailing address
508 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 744-0024
(941) 746-1048
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7954
RAILROAD MEDICARE
FL
Enumeration date
08/23/2006
Last updated
12/18/2007
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