Organization
PENSACOLA NEPHROLOGY, PA
Active
Parent organization
PENSACOLA NEPHROLOGY, PA
Other names
Renalus Center for Kidney Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENSACOLA NEPHROLOGY, PA
Authorized official
JUSTIN DANSBY (CFO)
(850) 444-7000
Entity
Organization
Contact information
Practice address
319 GREEN ACRES RD STE 103, FORT WALTON BEACH, FL 32547-1170
(850) 862-2385
(850) 862-0482
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
01
—
0358
MED3000/HEALTH 1ST NETWOR
FL
05
—
256870500
—
FL
05
—
256870501
—
FL
05
—
256870502
—
FL
05
—
256870503
—
FL
05
—
256870504
—
FL
05
—
256870505
—
FL
05
—
256870506
—
FL
05
—
256870507
—
FL
05
—
256870508
—
FL
05
—
529904030
—
AL
01
—
99659
BCBS OF FLORIDA
FL
01
—
CF9776
RR MEDICARE
—
Enumeration date
06/12/2006
Last updated
02/19/2025
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