Organization
CHARLOTTE NEPHROLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LALITA THATTE MD (VICE PRESIDENT)
(941) 629-4676
Entity
Organization
Contact information
Practice address
3300 TAMIAMI TRL, STE 101A, PORT CHARLOTTE, FL 33952-8054
(941) 629-4676
(941) 629-1522
Mailing address
3300 TAMIAMI TRAIL, SUITE 101A, PORT CHARLOTTE, FL 33952-8054
(941) 629-4676
(941) 629-1522
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251353600
—
FL
Enumeration date
05/18/2006
Last updated
03/25/2010
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