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Organization

ATLANTIC KIDNEY CENTERS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARIETTA HOLMES (ADMINISTRATOR)
(561) 845-2888
Entity
Organization

Contact information

Practice address
4700 N CONGRESS AVE, STE 104, WEST PALM BEACH, FL 33407-3282
(561) 845-2888
(561) 845-7282
Mailing address
4700 N CONGRESS AVE, STE 104, WEST PALM BEACH, FL 33407-3282
(561) 845-2888
(561) 845-7282

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209348
AMERIGROUP
05
21209330
FL
01
V7Q
BCBS OF FL
Enumeration date
11/10/2005
Last updated
08/22/2020
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