Organization
BRONSON DIALYSIS LLC
Active
Other names
Lake Seminole Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
10799 PARK BLVD, SEMINOLE, FL 33772-5420
(727) 319-0180
(727) 319-0175
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, 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
—
020718000
—
FL
Enumeration date
04/22/2016
Last updated
01/21/2021
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