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NPI Code Detail

MEDICARE: FLORIDA DIALYSIS CENTER OF ORLANDO LLC

MEDICARE: FLORIDA DIALYSIS CENTER OF ORLANDO 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

Other Identifiers

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

General Provider Information

NPI Number : 1538482740
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA DIALYSIS CENTER OF ORLANDO LLC
Provider Business Mailing Address
First Line : 1711 35TH ST
Second Line : UNITS 109 &110
City : ORLANDO
State : FL
Zip : 32839-8860
Country : US
Telephone Number : 407-648-9722
Fax Number : 407-648-9723
Provider Business Practice Location Address
First Line : 1711 35TH ST
Second Line : UNITS 109 & 110
City : ORLANDO
State : FL
Zip : 32839-8860
Country : US
Telephone Number : 407-648-9722
Fax Number : 407-648-9723
Authorized Official
Title or Position : CHIEF NURSING OFFICER
Name : SARA ANNE BRADY
Credential :
Telephone Number : 208-371-7878
Provider Enumeration Date : 03/03/2010
Last Update Date : 05/27/2026

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Directions to “FLORIDA DIALYSIS CENTER OF ORLANDO LLC ” Practice Location

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