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General NPI Number Information
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NPI Number | 1902975824
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE KIDNEY CARE, INC.
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 19133 HILLIARD BLVD
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City | ROCKY RIVER
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State | OH
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Zip | 44116-2907
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Country | US
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Telephone | 216-228-5500
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Fax | 216-227-2628
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Provider Business Mailing Address
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Address Line | 19133 HILLIARD BLVD
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City | ROCKY RIVER
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State | OH
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Zip | 44116-2907
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Country | US
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Telephone | 216-228-5500
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Fax | 216-227-2628
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD PATRICK FLAUTO
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Credential | D.O.
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Telephone | 440-292-0226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35-072868A
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 34-006702F
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License Number State | OH
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