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General NPI Number Information
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NPI Number | 1245875483
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Entity Type | Organization
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Legal Business Name | ARC DIALYSIS MIAMI LAKES, LLC
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 5600 NW 167TH ST
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City | MIAMI GARDEN
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State | FL
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Zip | 33014-6135
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Country | US
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Telephone | 786-661-2178
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Fax |
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Provider Business Mailing Address
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Address Line | 5600 NW 167TH ST
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City | MIAMI GARDEN
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State | FL
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Zip | 33014-6135
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Country | US
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Telephone | 786-661-2178
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YOSMANY PAEZ
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Credential |
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Telephone | 786-661-2178
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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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