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General NPI Number Information
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NPI Number | 1326521436
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Entity Type | Organization
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Legal Business Name | KIDNEY HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 11501 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33165-3313
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Country | US
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Telephone | 786-370-9720
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Fax |
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Provider Business Mailing Address
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Address Line | 11103 NW 7TH ST APT 103
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City | MIAMI
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State | FL
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Zip | 33172-3671
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Country | US
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Telephone | 786-370-9720
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Fax | 305-448-6268
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOSE ENRIQUE ALFONZO
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Credential |
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Telephone | 786-370-9720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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