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General NPI Number Information
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NPI Number | 1538817010
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Entity Type | Organization
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Legal Business Name | NEPHROGENX
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 4101 NW 4TH ST STE 411
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City | PLANTATION
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State | FL
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Zip | 33317-2836
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Country | US
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Telephone | 954-591-4546
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N FEDERAL HWY STE 200
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City | BOCA RATON
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State | FL
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Zip | 33432-2813
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Country | US
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Telephone | 954-591-4546
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | MR. CLEMENT MICHAEL PARTAP JR.
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Credential | NP
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Telephone | 954-591-4546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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