Organization
KIDNEY DISEASE CONSULTANTS OF BRADENTON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS NEWBY BRAXTAN III M.D. (PRESIDENT)
(941) 744-0024
Entity
Organization
Contact information
Practice address
508 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 744-0024
(941) 746-1048
Mailing address
508 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 744-0024
(941) 746-1048
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7954
RAILROAD MEDICARE
FL
Enumeration date
08/23/2006
Last updated
12/18/2007
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