Organization
FORT MYERS KIDNEY CENTER LLC
Active
Other names
Fort Myers Kidney Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
14181 S TAMIAMI TRL, SUITE 120, FORT MYERS, FL 33912-1939
(239) 415-1062
(239) 415-1063
Mailing address
14181 S TAMIAMI TRL, SUITE 120, FORT MYERS, FL 33912-1939
(239) 415-1062
(239) 415-1063
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
05
—
010564500
—
FL
Enumeration date
06/25/2013
Last updated
01/11/2023
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