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General NPI Number Information
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NPI Number | 1346522679
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA DIALYSIS CENTER CORP
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 8057 NW 155TH ST
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5874
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Country | US
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Telephone | 786-400-1379
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Fax | 786-513-0428
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Provider Business Mailing Address
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Address Line | 8057 NW 155TH ST
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5874
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Country | US
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Telephone | 786-400-1379
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Fax | 786-513-0428
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Authorized Official
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Title or Position | CEO
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Name | MRS. YIZEL AMADOR
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Credential |
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Telephone | 786-400-1379
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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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