| NPI | 1104019447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH CARRASCO Administrator 954-962-9640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2020-08-11 |