Organization
LIGHTHOUSE RENAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL RAMOS (PRESIDENT)
(786) 286-1084
Entity
Organization
Contact information
Practice address
951 NW 13TH ST STE 5B, BOCA RATON, FL 33486-2337
(786) 286-1084
Mailing address
2104 HUNTLEIGH PT, ORLANDO, FL 32835-5938
(786) 286-1084
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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