NEPHROLOGY SPECIALISTS OF FLORIDA, LLC.
Complete NPI Record 1477083269
Internal Medicine - Nephrology in Coral Gables, FL

Active since June 14, 2017
747 PONCE DE LEON BLVD STE 605, CORAL GABLES, FL 33134(305) 407-9900 Get Directions

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Dec 5, 2017 and 1 more (4 updates tracked since 2017).

Complete NPI Dataset

This page contains the complete raw NPPES record for Nephrology Specialists Of Florida, Llc. (NPI 1477083269), an internal medicine organization in Coral Gables, FL. All 37 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1477083269
Field 1/37
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Field 2/37
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
Field 3/37
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: NEPHROLOGY SPECIALISTS OF FLORIDA, LLC.
Field 4/37
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: PO BOX 652256
Field 5/37
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: MIAMI
Field 6/37
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: FL
Field 7/37
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 332652256
Field 8/37
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 9/37
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 3054079900
Field 10/37
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 8889812863
Field 11/37
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 747 PONCE DE LEON BLVD STE 605
Field 12/37
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CORAL GABLES
Field 13/37
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: FL
Field 14/37
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 331342074
Field 15/37
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 16/37
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3054079900
Field 17/37
The telephone number associated with the location address of the provider being identified.
Authorized Official Last Name: CARDONA-GUZMAN
Field 20/37
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JOSE
Field 21/37
The first name of the authorized official.
Authorized Official Middle Name: M
Field 22/37
The middle name of the authorized official.
Authorized Official Title or Position: OWNER
Field 23/37
The title or position of the authorized official.
Authorized Official Telephone Number: 3054079900
Field 24/37
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207RN0300X
Field 25/37
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Field 26/37
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Other Provider Identifier 1: 005961600
Field 27/37
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 1: 05
Field 28/37
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 1: FL
Field 29/37
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier 2: GI3222Z
Field 30/37
An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 2: 01
Field 31/37
A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
Other Provider Identifier State 2: FL
Field 32/37
The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
Other Provider Identifier Issuer 2: MEDICARE
Field 33/37
The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Is Organization Subpart: N
Field 34/37
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Name Prefix Text: DR.
Field 35/37
The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.
Authorized Official Credential Text: M.D.
Field 36/37
The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP
Field 37/37
Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.

Secondary Practice Locations 1

Additional practice locations on file with NPPES beyond the primary practice address.

12905 SW 42nd Street, Suite 213
Location 1/1
Miami, FL 33175-2912 · Phone (305) 705-5651 · Fax (888) 981-2863

Other Provider Identifiers 2

Legacy and payer-issued identifiers reported to the NPPES registry for this provider.

005961600 Medicaid
Identifier 1/2
State: FL
GI3222Z Other
Identifier 2/2
State: FL · Issuer: Medicare
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