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Organization

PENSACOLA NEPHROLOGY, PA

Active
Other names
Renalus Center for Kidney Care
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN DANSBY (CFO)
(850) 444-4700
Entity
Organization

Contact information

Practice address
1619 CREIGHTON RD STE 1, PENSACOLA, FL 32504-7152
(850) 444-4700
(850) 434-8144
Mailing address
PO BOX 11037, PENSACOLA, FL 32524-1037
(850) 444-4700
(850) 444-7497

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
256870500
FL
05
256870509
FL
05
256870510
FL
05
256870512
FL
05
256870513
FL
01
CF9776
RRB PTAN
FL
01
CF9777
RRB PTAN
AL
Enumeration date
06/01/2005
Last updated
02/19/2025
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