Organization
FLORIDA KIDNEY PHYSICIANS, LLC
Active
Parent organization
FLORIDA KIDNEY PHYSICIANS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA KIDNEY PHYSICIANS, LLC
Authorized official
MARIA ELENA RIVERA (CREDENTIALING SUPERVISOR)
(480) 610-6100
Entity
Organization
Contact information
Practice address
2585 HERSCHEL ST, JACKSONVILLE, FL 32204-4557
(904) 388-2678
(904) 388-6776
Mailing address
12662 TELECOM DR, TEMPLE TERRACE, FL 33637-0935
(813) 910-0030
(813) 971-6473
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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