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General NPI Number Information
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NPI Number | 1295104776
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Entity Type | Organization
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Legal Business Name | NEPHROLOGY INSTITUTE OF SOUTH FL LLC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 7392 NW 35TH TER STE 306
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City | MIAMI
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State | FL
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Zip | 33122-1260
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Country | US
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Telephone | 786-703-4932
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Fax | 954-337-3776
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Provider Business Mailing Address
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Address Line | 8210 SW 12TH TER
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City | MIAMI
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State | FL
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Zip | 33144-4330
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAVIER EMILIO ALFONSO
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Credential | MD
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Telephone | 786-703-4932
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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 | ME111392
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License Number State | FL
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