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

Jacksonville Kidney Center LLC

Organization Nephrology Physician · NPI 1255647491

Jacksonville Kidney Center LLC provides Nephrology Physician services in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2010.

Licensed in
FL
In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13241 Bartram Park Blvd Unit 409
Jacksonville, FL 32258-5237
Phone: (904) 400-6800
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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 ME 98954 (FL)

Record details

NPI number1255647491
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Koteswari Kancha — President · (904) 647-8207
NPI enumeratedAugust 25, 2010
Last updated in NPPESDecember 8, 2016
Mailing address10036 Deercreek Club Rd E, Jacksonville, FL 32256-1457

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