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General NPI Number Information
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NPI Number | 1194170852
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Entity Type | Organization
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Legal Business Name | PERITONEAL DIALYSIS CENTER INC.
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 714 W 51ST ST
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2615
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Country | US
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Telephone | 954-709-9793
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Fax | 888-349-8679
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Provider Business Mailing Address
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Address Line | 50 EAST SAMPLE ROAD SUITE 301A
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City | POMPANO BEACH
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State | FL
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Zip | 33064-3552
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Country | US
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Telephone | 954-709-9793
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Fax | 888-349-8679
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Authorized Official
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Title or Position | COO
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Name | MARCIA SANTOS
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Credential |
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Telephone | 954-709-9793
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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 | FL
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