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Organization
ATLANTIC KIDNEY CENTERS INC
Active
Organization
ATLANTIC KIDNEY CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIETTA HOLMES (ADMINISTRATOR)
(561) 845-2888
Entity
Organization
Contact information
Practice address
4700 N CONGRESS AVE, STE 104, WEST PALM BEACH, FL 33407-3282
(561) 845-2888
(561) 845-7282
Mailing address
4700 N CONGRESS AVE, STE 104, WEST PALM BEACH, FL 33407-3282
(561) 845-2888
(561) 845-7282
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209348
AMERIGROUP
—
05
—
21209330
—
FL
01
—
V7Q
BCBS OF FL
—
Enumeration date
11/10/2005
Last updated
08/22/2020
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