MEDICARE: GREATER MIAMI NEPHROLOGY ASSOCIATES PA

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME26504	FL
2	207RN0300X	Nephrology Physician

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1003082876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER MIAMI NEPHROLOGY ASSOCIATES PA

Provider Business Mailing Address
First Line	:	16501 NW 2ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-6005
Country	:	US
Telephone Number	:	305-354-4558
Fax Number	:	305-354-3884

Provider Business Practice Location Address
First Line	:	16501 NW 2ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-6005
Country	:	US
Telephone Number	:	305-354-4558
Fax Number	:	305-354-3884

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CARL S GOLDSAND
Credential	:	M.D.
Telephone Number	:	305-354-4558

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	11/21/2022

701 NW 27TH AVE
MIAMI, FL
33125-3012

Practice Phone: 786-744-1900
Practice Fax: 305-760-4141