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Organization

MANAGEMENT RENAL GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JORGE FERNANDEZ (OWNER)
(786) 486-0821
Entity
Organization

Contact information

Practice address
4742 SW 74TH AVE, MIAMI, FL 33155-4457
(786) 486-0821
Mailing address
9701 BEL AIRE DR, CUTLER BAY, FL 33157-7852
(786) 306-4118

Taxonomy

Speciality
Code
Description
License number
State
246ZN0300X
Nephrology Specialist/Technologist
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
332BD1200X
Dialysis Equipment & Supplies (DME)

Other

Enumeration date
05/01/2019
Last updated
05/01/2019
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