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Organization
TREASURE COAST NEPHROLOGY LLC
Active
Organization
TREASURE COAST NEPHROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
B AURORA F TOMITA MD (MANAGER)
(772) 465-1170
Entity
Organization
Contact information
Practice address
2000 HARTMAN RD STE 1, FORT PIERCE, FL 34947-4413
(772) 465-1170
Mailing address
2000 HARTMAN RD STE 1, FORT PIERCE, FL 34947-4413
(772) 465-1170
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105289000
—
FL
Enumeration date
12/04/2019
Last updated
10/01/2020
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