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General NPI Number Information
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NPI Number | 1538253778
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA NEPHROLOGY ASSOCIATES P A
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 2951 NW 49TH AVE SUITE #101
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-1600
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Country | US
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Telephone | 954-739-2511
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Fax | 954-739-9239
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Provider Business Mailing Address
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Address Line | 2951 NW 49TH AVE SUITE #101
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-1600
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Country | US
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Telephone | 954-739-2511
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Fax | 954-739-9239
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT PERRY GERONEMUS
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Credential | M.D.
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Telephone | 954-739-2511
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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 | ME0036206
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License Number State | FL
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