KIDNEY DOCTORS DIALYSIS CENTER INC NPI 1538648407

NPI Information

NPI: 1538648407
Provider Name: KIDNEY DOCTORS DIALYSIS CENTER INC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 10D2158121

Address:
12145 PEMBROKE RD
PEMBROKE PINES, FL
ZIP 33025
Phone: (954) 743-5804
Get Directions

KIDNEY DOCTORS DIALYSIS CENTER INC is an end-stage renal disease (esrd) treatment clinic center in Pembroke Pines, FL. KIDNEY DOCTORS DIALYSIS CENTER INC NPI is 1538648407. The provider is registered as an organization entity type.

The provider's business location address is:

12145 PEMBROKE RD
PEMBROKE PINES, FL
ZIP 33025-727
Phone: (954) 743-5804
Fax: (954) 743-4747

The provider's authorized official is Francisco Jose Bernal Perez .
The authorized official title is Director/administrator/don and has the following contact phone number (786) 365-6624.

The CLIA number assigned to this NPI record is 10D2158121 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/10/2018 and was last updated on 5/26/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	102376800	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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