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 is a Nephrology Physician 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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