| Advanced Kidney Care Of Central | |
|
3175 Citrus Tower Blvd Clermont FL 34711-6803 | |
| (612) 396-8602 | |
| Not Available |
| Full Name | Advanced Kidney Care Of Central |
|---|---|
| Speciality | Internal Medicine |
| Location | 3175 Citrus Tower Blvd, Clermont, Florida |
| Authorized Official Name and Position | Bao Long Huynh (PRESIDENT) |
| Authorized Official Contact | 6123968602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Kidney Care Of Central 3175 Citrus Tower Blvd Clermont FL 34711-6803 Ph: (352) 240-3812 | Advanced Kidney Care Of Central 3175 Citrus Tower Blvd Clermont FL 34711-6803 Ph: (612) 396-8602 |
| NPI Number | 1144533175 |
|---|---|
| Provider Enumeration Date | 07/19/2010 |
| Last Update Date | 01/12/2012 |
| Medicare PECOS PAC ID | 1951594761 |
|---|---|
| Medicare Enrollment ID | O20101025000388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144533175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME101771 (Florida) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | ME101771 (Florida) | Primary |
| Provider Name | Bao L Huynh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1902979594 PECOS PAC ID: 0042386492 Enrollment ID: I20080909000085 |
| Provider Name | Usman M Lone |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1740442755 PECOS PAC ID: 7416197215 Enrollment ID: I20130627000635 |
| Provider Name | Palak Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164958112 PECOS PAC ID: 5890065999 Enrollment ID: I20170724000324 |
| Provider Name | Mohammed Said Malas |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1215249966 PECOS PAC ID: 4486893948 Enrollment ID: I20171115001253 |
| Provider Name | Milton F Ray |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1801248216 PECOS PAC ID: 4587057203 Enrollment ID: I20220201002860 |
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