Healthcare Provider Details
I. General information
NPI: 1578351219
Provider Name (Legal Business Name): KENDALL DIALYSIS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13500 N KENDALL DR STE 131
MIAMI FL
33186-1528
US
IV. Provider business mailing address
700 TAMARACK RD
STOWE VT
05672-4206
US
V. Phone/Fax
- Phone: 305-388-5222
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SCOTT
CRAWFORD
Title or Position: PRESIDENT
Credential: DVM
Phone: 508-944-6304