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Organization
CAPITAL NEPHROLOGY CLINIC, P.A.
Active
Organization
CAPITAL NEPHROLOGY CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA F HOFFMAN (CREDENTIALING MANAGER)
(850) 444-4700
Entity
Organization
Contact information
Practice address
1845 JACLIF CT, TALLAHASSEE, FL 32308
(850) 999-2328
(850) 320-6114
Mailing address
1845 JACLIF CT, TALLAHASSEE, FL 32308-4430
(850) 999-2328
(850) 320-6114
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME113752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018119800
—
FL
01
—
ME113752
FLORIDA MEDICAL LICENSE
FL
Enumeration date
07/08/2016
Last updated
10/16/2018
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