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NPI Code Detail

MEDICARE: NNA OF FLORIDA LLC

MEDICARE: NNA OF FLORIDA 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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1437261278
Entity Type Code : Organization
Provider Name (Legal Business Name) : NNA OF FLORIDA LLC
Provider Business Mailing Address
First Line : 1630 S TUTTLE AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34239-3108
Country : US
Telephone Number : 941-373-9270
Fax Number : 941-954-3578
Provider Business Practice Location Address
First Line : 1630 S TUTTLE AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34239-3108
Country : US
Telephone Number : 941-373-9270
Fax Number : 941-954-3578
Authorized Official
Title or Position : TREASURER
Name : MARK FAWCETT
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 08/31/2006
Last Update Date : 09/21/2010

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Directions to “NNA OF FLORIDA LLC ” Practice Location

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