JACKSONVILLE KIDNEY CENTER LLC
Osteopathic Medicine at Bartram Park Blvd, Jacksonville, FL

License number
Florida ME 98954
Category
Osteopathic Medicine
Type
Nephrology
Owner
Name: KOTESWARI KANCHA MD
Title: PRESIDENT
Phone: (904) 647-8207
Address
Address
13241 Bartram Park Blvd UNIT 409, Jacksonville, FL 32258
National Provider ID: 1255647491
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about JACKSONVILLE KIDNEY CENTER LLC at bizstanding.com

Jacksonville Kidney Center, LLC

Jacksonville, FL

Registration:
Aug 16, 2010
Addresses:
13241 Bartram Park Blvd, Jacksonville, FL 32258
3993 Reds Gait Ln, Jacksonville, FL 32223
State ID:
L10000085483
Business type:
Florida Limited Liability
Treasurer:
Koteswari Kancha (Treasurer)
Agent:
The Farah Law Group

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