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General NPI Number Information
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NPI Number | 1033838230
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Entity Type | Organization
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Legal Business Name | KIDNEY DOCTORS DIALYSIS CENTER INC
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 18369 NW 27TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-3169
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Country | US
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Telephone | 305-707-5243
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Fax | 305-707-5414
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Provider Business Mailing Address
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Address Line | 18369 NW 27TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-3169
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Country | US
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Telephone | 305-707-5243
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Fax | 305-707-5414
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Authorized Official
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Title or Position | DON/ADMINISTRATOR
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Name | FRANCISCO J BERNAL PEREZ
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Credential | DNP
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Telephone | 786-365-6624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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