Healthcare Provider Details

I. General information

NPI: 1710899463
Provider Name (Legal Business Name): KIDNEY CARE PLUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 SW 8TH ST
CORAL GABLES FL
33134-2543
US

IV. Provider business mailing address

4580 SW 8TH ST
CORAL GABLES FL
33134-2543
US

V. Phone/Fax

Practice location:
  • Phone: 954-228-8180
  • Fax: 954-228-8183
Mailing address:
  • Phone: 954-228-8180
  • Fax: 954-228-8183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PEDRO HERNANDEZ-LOPEZ
Title or Position: OWNER
Credential: MD
Phone: 954-228-8180