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Organization

ADVANCED KIDNEY CARE OF CENTRAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BAO LONG HUYNH MD (PRESIDENT)
(612) 396-8602
Entity
Organization

Contact information

Practice address
3175 CITRUS TOWER BLVD, CLERMONT, FL 34711-6803
(612) 396-8602
Mailing address
3175 CITRUS TOWER BLVD, CLERMONT, FL 34711-6803
(352) 240-3812

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME101771
FL
207RN0300X
Nephrology Physician
Primary
ME101771
FL

Other

Enumeration date
07/19/2010
Last updated
01/12/2012
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