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General NPI Number Information
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NPI Number | 1861038820
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Entity Type | Organization
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Legal Business Name | ACE KIDNEY LLC
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 9100 CONROY WINDERMERE RD STE 200
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City | WINDERMERE
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State | FL
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Zip | 34786-8431
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Country | US
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Telephone | 407-205-8507
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Fax | 615-235-1250
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Provider Business Mailing Address
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Address Line | 2582 MAGUIRE RD UNIT 249
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City | OCOEE
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State | FL
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Zip | 34761-4749
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Country | US
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Telephone | 407-205-8507
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SANGHAMITRA SADHU
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Credential | MD
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Telephone | 407-205-8507
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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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