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General NPI Number Information
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NPI Number | 1699755355
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Entity Type | Organization
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Legal Business Name | HALLANDALE ARTIFICIAL KIDNEY CENTER, INC.
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2655 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4840
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Country | US
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Telephone | 954-925-9909
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Fax | 954-927-5852
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Provider Business Mailing Address
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Address Line | 7061 CYPRESS RD SUITE 104
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City | PLANTATION
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State | FL
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Zip | 33317-2243
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Country | US
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Telephone | 954-474-7701
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Fax | 954-474-7702
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Authorized Official
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Title or Position | DIRECTOR/VICE PRESIDENT
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Name | MS. VICKI L BURRIER
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Credential | RN, MBA
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Telephone | 954-474-7702
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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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