Healthcare Provider Details

I. General information

NPI: 1881153674
Provider Name (Legal Business Name): KIDNEY HEALTH SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 02/08/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7261 SHERIDAN ST STE 360
HOLLYWOOD FL
33024-2726
US

IV. Provider business mailing address

5411 NW 87TH AVE
LAUDERHILL FL
33351-4852
US

V. Phone/Fax

Practice location:
  • Phone: 954-226-0121
  • Fax: 866-981-2156
Mailing address:
  • Phone: 954-999-8489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EMILIAN CRISTEA
Title or Position: OWNER
Credential: MD
Phone: 954-999-8489