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FLORIDA KIDNEY PHYSICIANS, LLC
NPI 1205409752
Internal Medicine - Nephrology in Port Charlotte, FL

Active since July 22, 2021CLIA 10D1008195 · Waiver
3221 TAMIAMI TRL, PORT CHARLOTTE, FL 33952(941) 505-8720(855) 793-3651 Get Directions Write a Review

NPPES record last updated: July 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Florida Kidney Physicians, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FLORIDA KIDNEY PHYSICIANS, LLC (NPI 1205409752) is a healthcare organization registered as a nephrology in Port Charlotte, Florida and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through January 13, 2027 and lists Maria Elena Rivera, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1205409752
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameFLORIDA KIDNEY PHYSICIANS, LLC
Location Address3221 TAMIAMI TRLPort Charlotte, FL 33952-8002
Mailing Address3221 Tamiami TrlPort Charlotte, FL 33952-8002 · (941) 505-8720 · Fax (855) 793-3651
Phone(941) 505-8720
Fax(855) 793-3651
Organization SubpartNo
Authorized OfficialMaria Elena RiveraCredentialing Manager · (480) 610-6100
Enumeration DateJuly 22, 2021
NPPES CertifiedJuly 22, 2021
✔ NPI 1205409752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
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.
3221 TAMIAMI TRL, Port Charlotte, FL 33952
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1008195

Florida Kidney Physicians, LLC · Port Charlotte, FL
Active · expires Jan 13, 2027
CLIA Number10D1008195
Laboratory TypePhysician Office
Certificate Effective DateJanuary 14, 2025
Certificate Expiration DateJanuary 13, 2027
Laboratory DirectorKianoosh Kaveh
Laboratory Phone(941) 505-8720
Laboratory LocationFlorida Kidney Physicians, LLC2852 Tamiami Trail - Suites 1-4, Port Charlotte, FL 33952
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KIANOOSH KAVEH DO
Internal Medicine (Nephrology)
3221 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Charlotte County (941) 505-8720
MRS. ANDREA BRIGGS OLDS RD LD/N
Dietitian, Registered (Nutrition, Renal)
3221 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Charlotte County (941) 505-8720
DR. ROHIT PANKHANIYA MD
Internal Medicine (Nephrology)
3221 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Charlotte County (941) 505-8720
FLORIDA KIDNEY DISEASE & HYPERTENSION CTR PA
Internal Medicine (Nephrology)
3221 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Charlotte County (941) 505-8720
DR. NANDHEESHA HANUMANTHAPPA MD
Internal Medicine (Nephrology)
3221 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Charlotte County (941) 505-8720
KIANOOSH KAVEH DO PA
Internal Medicine (Nephrology)
3221 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Charlotte County (941) 505-8720
DR. DOROTHY K NEMEC M.D.
Internal Medicine (Nephrology)
3221 TAMIAMI TRL
PORT CHARLOTTE, FL 33952
Charlotte County (941) 505-8720

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Florida Kidney Physicians, LLC's NPI number?

The NPI number for Florida Kidney Physicians, LLC is 1205409752. It was assigned to this organization in the NPPES registry on July 22, 2021.

Where is Florida Kidney Physicians, LLC located?

Florida Kidney Physicians, LLC is located at 3221 Tamiami Trl, Port Charlotte, FL 33952. The listed phone number is (941) 505-8720.

What is Florida Kidney Physicians, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does Florida Kidney Physicians, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1008195) is associated with this NPI, valid through January 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Florida Kidney Physicians, LLC was last updated on July 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.