TREASURE COAST NEPHROLOGY LLC NPI 1922645324

NPI Information

  • NPI: 1922645324
  • Provider Name: TREASURE COAST NEPHROLOGY LLC
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • CLIA Number: 10D2179204
  • Address: 2000 HARTMAN RD STE 1
    FORT PIERCE, FL
    ZIP 34947
  • Phone: (772) 465-1170

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NPI Details

TREASURE COAST NEPHROLOGY LLC is a nephrology internal medicine in Fort Pierce, 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. TREASURE COAST NEPHROLOGY LLC NPI is 1922645324. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2000 HARTMAN RD STE 1
FORT PIERCE, FL
ZIP 34947-413
Phone: (772) 465-1170

The provider's authorized official is B Aurora F Tomita .
The authorized official title is Manager and has the following contact phone number (772) 465-1170.

The CLIA number assigned to this NPI record is 10D2179204 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/4/2019 and was last updated on 10/1/2020.

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
1207RN0300XInternal MedicineNephrologyYes

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
1105289000MEDICAIDFLORIDA

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: 11/21/2025

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