Healthcare Provider Details

I. General information

NPI: 1447387436
Provider Name (Legal Business Name): AMIT K KAMRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6766 W SUNRISE BLVD SUITE 100
PLANTATION FL
33313-6072
US

IV. Provider business mailing address

40 VALLEY STREAM PKWY SUITE 100
MALVERN PA
19355-1407
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-8472
  • Fax: 954-583-8476
Mailing address:
  • Phone: 610-644-8900
  • Fax: 484-924-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD440282
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME115193
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: