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General NPI Number Information
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NPI Number | 1780547323
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Entity Type | Organization
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Legal Business Name | KJ RENAL LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | B1 CALLE 1 ALTOS FARMACIA MEDINA #2 VILLAS DE LOIZA
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City | CANOVANAS
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State | PR
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Zip | 00729-4116
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Country | US
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Telephone | 787-886-3254
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Fax | 787-957-1555
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Provider Business Mailing Address
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Address Line | A8 VIA HORIZONTE
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City | SAN JUAN
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State | PR
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Zip | 00924-4461
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Country | US
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Telephone |
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Fax | 787-957-1555
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Authorized Official
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Title or Position | CEO
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Name | KRYSTAHL Z ANDUJAR RIVERA
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Credential | MD
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Telephone | 787-956-8918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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