MEDICARE: BRONSON DIALYSIS LLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215381553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONSON DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPARTMENT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:	615-320-4593
Fax Number	:	800-293-5872

Provider Business Practice Location Address
First Line	:	10799 PARK BLVD
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-5420
Country	:	US
Telephone Number	:	727-319-0180
Fax Number	:	727-319-0175

Authorized Official
Title or Position	:	CHIEF ACCOUNTING OFFICER
Name	:	JOHN WINSTEL
Credential	:
Telephone Number	:	253-733-4501

Provider Enumeration Date	:	04/22/2016
Last Update Date	:	01/21/2021

Similar Medicare Providers

1467111278 — SOUTHEAST EYE INSTITUTE, PA
Practice Location Address:

10755 PARK BLVD
SEMINOLE, FL
33772-5420

Practice Phone: 727-392-0907
Practice Fax:

1760523294 — KIDNEY LIFE INCORPORATED
Practice Location Address:

10755 PARK BLVD , SUITE B
SEMINOLE, FL
33772-5420

Practice Phone: 727-393-5551
Practice Fax: 727-398-1971

1174656151 — DAVID T NGUYEN D.O.
Practice Location Address:

10799 PARK BLVD
SEMINOLE, FL
33772-5420

Practice Phone: 727-547-8425
Practice Fax: 813-635-2699

1710193511 — VISION SPECIALTY ASSOCIATES, P.A.
Practice Location Address:

10755 PARK BLVD
SEMINOLE, FL
33772-5420

Practice Phone: 727-392-0907
Practice Fax: 727-592-2569

1922215136 — OPTIMART, INC.
Practice Location Address:

10755 PARK BLVD
SEMINOLE, FL
33772-5420

Practice Phone: 727-392-0907
Practice Fax: 727-592-2569

1427636349 — DOGUKAN ACIKGOZ DO
Practice Location Address:

10799 PARK BLVD
SEMINOLE, FL
33772-5420

Practice Phone: 727-547-8425
Practice Fax: 813-635-2699

Directions to “BRONSON DIALYSIS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.