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 is a Nephrology Physician 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
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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