Organization
YARGOL DIALYSIS LLC
Active
Other names
Winter Haven South Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
7220 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-3217
(863) 324-5040
(863) 324-8492
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4593
(800) 293-5872
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
—
012387900
—
FL
Enumeration date
11/02/2013
Last updated
02/05/2024
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