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Organization

PURE LIFE RENAL OF PERIMETER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFF FERNANDEZ (CFO)
(954) 962-5734
Entity
Organization

Contact information

Practice address
6160 PEACHTREE DUNWOODY RD, SUITE A-110, ATLANTA, GA 30328-4578
(954) 962-5733
Mailing address
4000 HOLLYWOOD BLVD, SUITE 300N, HOLLYWOOD, FL 33021-6751
(954) 962-5734

Taxonomy

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

Other

Enumeration date
12/07/2016
Last updated
08/12/2022
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