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General NPI Number Information
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NPI Number | 1306730577
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Entity Type | Organization
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Legal Business Name | FLORIDA DEC LLC
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 11181 HEALTH PARK BLVD STE 2265
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City | NAPLES
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State | FL
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Zip | 34110-5735
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Country | US
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Telephone | 219-308-3494
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Fax |
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Provider Business Mailing Address
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Address Line | 11181 HEALTH PARK BLVD STE 2265
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City | NAPLES
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State | FL
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Zip | 34110-5735
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Country | US
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Telephone | 219-308-3494
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | MR. NELSON ANDRES FERNANDEZ JR.
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Credential |
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Telephone | 239-837-3374
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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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