MEDICARE: BIO-MEDICAL APPLICATIONS OF FLORIDA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1174570196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIO-MEDICAL APPLICATIONS OF FLORIDA, INC.

Provider Business Mailing Address
First Line	:	920 WINTER ST
Second Line	:	FMCNA CKD SERVICES
City	:	WALTHAM
State	:	MA
Zip	:	02451-1521
Country	:	US
Telephone Number	:	781-699-4160
Fax Number	:	781-699-4046

Provider Business Practice Location Address
First Line	:	2348 E OCEAN BLVD
Second Line	:	TREASURE COAST KIDNEY CENTER NORTH - CKD SERVICES
City	:	STUART
State	:	FL
Zip	:	34996-3310
Country	:	US
Telephone Number	:	772-286-2470
Fax Number	:	772-223-5829

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. MARK FAWCETT
Credential	:
Telephone Number	:	781-699-2668

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	05/28/2008

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