MEDICARE: RENAL CAREPARTNERS OF HIALEAH, 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

General Provider Information

NPI Number	:	1588640130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL CAREPARTNERS OF HIALEAH, LLC

Provider Business Mailing Address
First Line	:	14361 COMMERCE WAY
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1565
Country	:	US
Telephone Number	:	305-512-0014
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3504
Country	:	US
Telephone Number	:	305-512-0014
Fax Number	:

Authorized Official
Title or Position	:	VP, CFO
Name	:	ORESTES LUGO
Credential	:
Telephone Number	:	305-512-0014

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	08/22/2020

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