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General NPI Number Information
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NPI Number | 1700625530
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Entity Type | Organization
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Legal Business Name | KIDNEY INTELLIGENCE LLC
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Dates
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Enumeration Date | 05/21/2024
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | CARR PR 402 KM 2.9 BO QUEBRADA LARGA
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 939-301-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 270 CALLE DE LA CANDELARIA UNIT 3374
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City | MAYAGUEZ
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State | PR
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Zip | 00681-8824
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Country | US
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Telephone | 939-301-3030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEAN O FLORES
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Credential | MD
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Telephone | 939-301-3030
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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 |
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License Number State |
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