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General NPI Number Information
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NPI Number | 1134273410
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Entity Type | Organization
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Legal Business Name | S W NEPHROLOGY SERVICES INC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 22655 BAYSHORE RD STE 110
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City | PORT CHARLOTTE
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State | FL
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Zip | 33980-2003
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Country | US
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Telephone | 941-629-7092
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Fax |
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Provider Business Mailing Address
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Address Line | 22655 BAYSHORE RD STE 110
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City | PORT CHARLOTTE
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State | FL
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Zip | 33980-2003
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Country | US
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Telephone | 941-629-7092
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISHNAMURTY VELAMAKANNI
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Credential | MD
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Telephone | 941-629-7092
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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 | ME73225
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License Number State | FL
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