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NPI Code Detail

MEDICARE: BROWARD KIDNEY CENTERS OF CORAL SPRINGS, LLC

MEDICARE: BROWARD KIDNEY CENTERS OF CORAL SPRINGS, 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/CenterFL

General Provider Information

NPI Number : 1447442116
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROWARD KIDNEY CENTERS OF CORAL SPRINGS, LLC
Provider Business Mailing Address
First Line : 850 RIVERSIDE DR
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-7010
Country : US
Telephone Number : 954-340-3353
Fax Number : 954-340-3354
Provider Business Practice Location Address
First Line : 850 RIVERSIDE DR
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-7010
Country : US
Telephone Number : 954-340-3353
Fax Number : 954-340-3354
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. MARY MITCHELL
Credential : RN
Telephone Number : 954-340-3353
Provider Enumeration Date : 08/15/2007
Last Update Date : 07/21/2022

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Directions to “BROWARD KIDNEY CENTERS OF CORAL SPRINGS, LLC ” Practice Location

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