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General NPI Number Information
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NPI Number | 1194178889
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Entity Type | Organization
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Legal Business Name | RENVIVA DIALYSIS CENTER OF CLEARWATER
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Dates
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Enumeration Date | 07/18/2016
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 401 CORBETT ST SUITE 250
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City | BELLEAIR
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State | FL
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Zip | 33756-7309
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Country | US
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Telephone | 727-281-4490
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Fax | 866-352-4339
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Provider Business Mailing Address
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Address Line | 213 PELICAN WAY
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City | DELRAY BEACH
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State | FL
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Zip | 33483-8011
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Country | US
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Telephone | 727-281-4490
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Fax | 866-352-4339
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Authorized Official
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Title or Position | MEMBER
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Name | MS. SANDRA D FRITZSCH
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Credential | JD
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Telephone | 513-673-5245
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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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