HYPERTENSION KIDNEY AND DIALYSIS SPECIALISTS
Osteopathic Medicine at Harrison Ave, Panama City, FL

License number
Florida ME0078033
Category
Osteopathic Medicine
Type
Nephrology
Owner
Name: MR. AHMAD OUSSAMA RIFAI M.D.
Title: SOLE MBR
Phone: (850) 215-5911
Address
Address 2
2507 Harrison Ave SUITE 101, Panama City, FL 32405
PO Box 1750, Lynn Haven, FL 32444
National Provider ID: 1447540612
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HYPERTENSION KIDNEY AND DIALYSIS SPECIALISTS, LLC

Panama City, FL  -  Lynn Haven, FL

Status:
Inactive
Industry:
Kidney Dialysis Centers
Doing business as:
Hypertension Kidney and Dialysis Specialists, Ll
Inactive reason:
Lc Amendment
Registration:
Jan 13, 2011
Inactive since:
Jul 27, 2011
Addresses:
2507 Harrison Ave SUITE 101, Panama City, FL 32405 (Physical)
Lynn Haven, FL 32444 (Mailing)
PO Box 1750, Lynn Haven, FL 32444
State ID:
L11000005681
Business type:
Florida Limited Liability Company
Managing Members:
A.o. Rifai, Md, Llc (Managing Member), 121 Cottonwood Cir, Lynn Haven, FL 32444 (Physical),Ahmad O. Rifai Managing Member, inactive
Agent:
Rifai, Ahmad O, Md,2507 Harrison Ave SUITE 101, Panama City, FL 32405 (Physical)
EIN:
274647939

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