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Organization

FLORIDA KIDNEY & HYPERTENSION CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAMA THAMBUGANIPALLE M.D. (PRESIDENT)
(904) 451-1005
Entity
Organization

Contact information

Practice address
2140 KINGSLEY AVE, SUITE 10, ORANGE PARK, FL 32073-5129
(904) 529-5252
(904) 529-5253
Mailing address
2140 KINGSLEY AVE, SUITE 10, ORANGE PARK, FL 32073-5180
(904) 529-5252
(904) 529-5253

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME93749
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54259
BCBS
FL
Enumeration date
04/16/2008
Last updated
06/10/2010
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