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General NPI Number Information
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NPI Number | 1396355525
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Entity Type | Organization
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Legal Business Name | KIDNEY PARTNERS CORAL GABLES LLC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 835 SW 37TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-4289
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Country | US
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Telephone | 305-329-2900
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Fax | 305-329-2901
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Provider Business Mailing Address
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Address Line | 219 NW 12TH AVE STE C4
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City | MIAMI
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State | FL
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Zip | 33128-2205
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Country | US
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Telephone | 305-329-2900
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Fax | 305-329-2901
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Authorized Official
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Title or Position | CEO
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Name | DR. JUAN M CUELLAR
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Credential | MD
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Telephone | 305-329-2900
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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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