Basic Information
| Provider Information | |||||||||
| NPI: | 1174009344 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KIDNEY AND HYPERTENSION OF THE PALM BEACHES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 JFK DR STE 134 | ||||||||
| Address2: | |||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334621133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616128080 | ||||||||
| FaxNumber: | 5619680660 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 JFK DR STE 134 | ||||||||
| Address2: | |||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334621133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616128080 | ||||||||
| FaxNumber: | 5619680660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2018 | ||||||||
| LastUpdateDate: | 02/22/2019 | ||||||||
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| AuthorizedOfficialLastName: | ABDELWAHED | ||||||||
| AuthorizedOfficialFirstName: | YEHIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5616128080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | ME114122 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.