| NPI | 1235211327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUKON K WANICH Administrator 321-452-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |