Organization
KIDNEY CLINIC OF JACKSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KADIR MANSUR MD (PRESIDENT/CO-OWNER)
(904) 296-8980
Entity
Organization
Contact information
Practice address
14546 OLD SAINT AUGUSTINE RD, 301, JACKSONVILLE, FL 32258-5468
(904) 296-8980
(904) 296-0698
Mailing address
14546 OLD SAINT AUGUSTINE RD, 301, JACKSONVILLE, FL 32258-5468
(904) 296-8980
(904) 296-0698
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
09/01/2009
Last updated
12/31/2009
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