| Compass Nephrology Care, Pllc | |
|
2685 Executive Park Dr Ste 5 Weston FL 33331-3651 | |
| (954) 590-0556 | |
| Not Available |
| Full Name | Compass Nephrology Care, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2685 Executive Park Dr Ste 5, Weston, Florida |
| Authorized Official Name and Position | Charles Aaron Bonanno (SOLE PROPRIETOR) |
| Authorized Official Contact | 9545900556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compass Nephrology Care, Pllc 2685 Executive Park Dr Ste 5 Weston FL 33331-3651 Ph: (954) 590-0556 | Compass Nephrology Care, Pllc 2685 Executive Park Dr Ste 5 Weston FL 33331-3651 Ph: (954) 590-0556 |
| NPI Number | 1053008318 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 12/05/2023 |
| Medicare PECOS PAC ID | 7214393255 |
|---|---|
| Medicare Enrollment ID | O20230518000174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053008318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Charles Aaron Bonanno |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447740014 PECOS PAC ID: 0143576660 Enrollment ID: I20230518000231 |
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