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Organization

ST. AUGUSTINE ARTIFICIAL KIDNEY CENTER, LTD.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. VICKI L BURRIER RN, MBA (DIRECTOR/VICE-PRESIDENT)
(954) 474-7701
Entity
Organization

Contact information

Practice address
264 SOUTHPARK CIR E, ST AUGUSTINE, FL 32086-5137
(904) 808-0445
(904) 808-0446
Mailing address
7061 CYPRESS RD, SUITE 104, PLANTATION, FL 33317-2243
(954) 474-7701
(954) 474-7702

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
V7A
BC/BS PROVIDER NO.
FL
Enumeration date
01/19/2006
Last updated
08/22/2020
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