MANDAL'S CONSERVATIVE NEPHROLOGY PRACTICE LLC NPI 1376904417

NPI Information

NPI: 1376904417
Provider Name: MANDAL'S CONSERVATIVE NEPHROLOGY PRACTICE, LLC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
800 ZEAGLER DR
PALATKA, FL
ZIP 32177
Phone: (904) 824-8158
Get Directions

MANDAL'S CONSERVATIVE NEPHROLOGY PRACTICE, LLC is a nephrology internal medicine in Palatka, FL. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. MANDAL'S CONSERVATIVE NEPHROLOGY PRACTICE, LLC NPI is 1376904417. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

800 ZEAGLER DR
PALATKA, FL
ZIP 32177-883
Phone: (904) 824-8158

The provider's authorized official is Anil Kumar Mandal .
The authorized official title is Owner and has the following contact phone number (904) 305-1234.

The enumeration date for this NPI number is 3/17/2016 and was last updated on 3/17/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology	ME0074439	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	255413500	MEDICAID	FLORIDA
2	42409U	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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