Organization
CFA KIDNEY & HYPERTENSION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUFUNMILOLA OLUWAKEMI DARAMOLA-OGUNWUYI MD (PRESIDENT)
(321) 214-4133
Entity
Organization
Contact information
Practice address
587 E STATE ROAD 434, SUITE 1011, LONGWOOD, FL 32750-5284
(321) 214-4133
(321) 214-4216
Mailing address
P O BOX 915467, LONGWOOD, FL 32791-5467
(321) 214-4133
(321) 214-4216
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
L06000028969
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14479901
CITRUS HEALTH CARE PLAN
—
05
—
276132700
—
FL
01
—
303267
AVMED
—
01
—
354671
WELLCARE
FL
01
—
56284
BLUE CROSS BLUE SHIELD
FL
01
—
7281278
CIGNA
—
01
—
DF1497
RAILROAD MEDICARE
FL
Enumeration date
07/01/2006
Last updated
03/03/2011
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