MEDICARE: SUNAPEE DIALYSIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184092116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNAPEE DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1154 CELEBRATION BLVD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34747-4605
Country	:	US
Telephone Number	:	407-566-1780
Fax Number	:	407-566-1756

Authorized Official
Title or Position	:	VP, LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	09/08/2015
Last Update Date	:	09/12/2025

Similar Medicare Providers

1043287550 — SOUTH CENTRAL FLORIDA DIALYSIS PARTNERS LLC
Practice Location Address:

1154 CELEBRATION BLVD
KISSIMMEE, FL
34747-4605

Practice Phone: 407-566-1780
Practice Fax: 407-566-1756

1730392382 — REBECCA FITE BROOKS MPH, RD, LDN, CSR
Practice Location Address:

1154 CELEBRATION BLVD
KISSIMMEE, FL
34747-4605

Practice Phone: 407-566-1780
Practice Fax: 407-566-1756

1386214963 — THE WOMENS CENTER OF ORLANDO LLC
Practice Location Address:

1148 CELEBRATION BLVD
CELEBRATION, FL
34747-4605

Practice Phone: 407-857-2502
Practice Fax: 407-857-1855

1295388403 — FAITH K KPANDEE
Practice Location Address:

7799 STYLES BLVD STE 203
KISSIMMEE, FL
34747-1657

Practice Phone: 850-209-0036
Practice Fax:

1073503272 — JIMSON CHIU HUNG TSE MD
Practice Location Address:

400 CELEBRATION PL
KISSIMMEE, FL
34747-4970

Practice Phone: 407-303-4000
Practice Fax:

1982677290 — MR. DREW J VAN DAM JR. ATC
Practice Location Address:

700 VICTORY WAY
KISSIMMEE, FL
34747-4100

Practice Phone: 407-939-2315
Practice Fax:

Directions to “SUNAPEE DIALYSIS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.