Healthcare Provider Details

I. General information

NPI: 1245752583
Provider Name (Legal Business Name): KIDNEY CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 E ALTAMONTE DR STE 213
ALTAMONTE SPRINGS FL
32701
US

IV. Provider business mailing address

661 E ALTAMONTE DR STE 213
ALTAMONTE SPRINGS FL
32701-5102
US

V. Phone/Fax

Practice location:
  • Phone: 407-951-5883
  • Fax: 407-951-8326
Mailing address:
  • Phone: 407-951-5883
  • Fax: 407-951-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SYED IRFAN QADRI
Title or Position: OWNER
Credential: MD
Phone: 407-951-5883