1. Home
  2. Directory
  3. Florida
  4. Fort Lauderdale
  5. Internal Medicine
  6. NPI Profile

360 MEDICAL PA
NPI 1508096330
Internal Medicine - Nephrology in Fort Lauderdale, FL

Active since July 14, 2009
2004 NE 49TH ST, FORT LAUDERDALE, FL 33308(954) 790-2251(954) 206-2200 Get Directions Write a Review

NPPES record last updated: August 4, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About 360 Medical Pa NPPES

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

360 MEDICAL PA (NPI 1508096330) is a healthcare organization registered as a nephrology in Fort Lauderdale, Florida and active in the NPI registry since July 2009. The organization lists Lan T Phan, President, as its authorized official.

NPPES Registry Identity

NPI1508096330
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business Name360 MEDICAL PA
Location Address2004 NE 49TH STFort Lauderdale, FL 33308-4524
Mailing Address2004 Ne 49th StFort Lauderdale, FL 33308-4524 · (954) 790-2251 · Fax (954) 206-2200
Phone(954) 790-2251
Fax(954) 206-2200
Organization SubpartNo
Authorized OfficialLan T PhanPresident · (954) 790-2251
Enumeration DateJuly 14, 2009
Last NPPES UpdateAugust 4, 2009
✔ NPI 1508096330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in FL · OS7637
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.
2004 NE 49TH ST, Fort Lauderdale, FL 33308
Open in Google Maps ↗

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

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 360 Medical PA's NPI number?

The NPI number for 360 Medical PA is 1508096330. It was assigned to this organization in the NPPES registry on July 14, 2009.

Where is 360 Medical PA located?

360 Medical PA is located at 2004 NE 49th St, Fort Lauderdale, FL 33308. The listed phone number is (954) 790-2251.

What is 360 Medical PA's specialty?

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

When was this NPI record last updated?

The NPPES record for 360 Medical PA was last updated on August 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.