Healthcare Provider Details

I. General information

NPI: 1457574808
Provider Name (Legal Business Name): SOUTH FLORIDA NEPHROLOGY CONSULTANTS PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 N FLAMINGO RD STE 265
PEMBROKE PINES FL
33028-1013
US

IV. Provider business mailing address

603 N FLAMINGO RD STE 265
PEMBROKE PINES FL
33028-1013
US

V. Phone/Fax

Practice location:
  • Phone: 954-986-9008
  • Fax: 954-986-6646
Mailing address:
  • Phone: 954-986-9008
  • Fax: 954-986-6646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. LINDA G ALLSHOUSE
Title or Position: ADMINISTRATOR
Credential: CMPE
Phone: 954-986-9008