Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

360 Medical PA

Organization Nephrology Physician · NPI 1508096330

360 Medical PA provides Nephrology Physician services in Fort Lauderdale, Florida. Licensed in Florida. Registered with an NPI since 2009.

Licensed in
FL
In the registry since
2009
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2004 NE 49th St
Fort Lauderdale, FL 33308-4524 Not confirmed with CMS for 17 years — call before visiting
Phone: (954) 790-2251
Fax: (954) 206-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence OS7637 (FL)

Record details

NPI number1508096330
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lan Phan — President · (954) 790-2251
NPI enumeratedJuly 14, 2009
Last updated in NPPESAugust 4, 2009
Mailing address2004 Ne 49th St, Fort Lauderdale, FL 33308-4524

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