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General NPI Number Information
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NPI Number | 1033620489
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE KIDNEY CARE INC
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 7351 W. OAKLAND PARK BLVD SUITE 105
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City | LAUDERHILL
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State | FL
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Zip | 33319
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Country | US
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Telephone | 954-908-5992
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Fax | 954-951-0787
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Provider Business Mailing Address
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Address Line | PO BOX 277711
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City | MIRAMAR
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State | FL
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Zip | 33027-7711
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Country | US
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Telephone | 954-908-5992
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Fax | 954-951-1171
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONES S JOHN
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Credential | DO
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Telephone | 954-908-5992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | OS11516
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License Number State | FL
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