Organization
PURE LIFE RENAL OF MIRAMAR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF FERNANDEZ (CFO)
(954) 962-5734
Entity
Organization
Contact information
Practice address
3180 S UNIVERSITY DR, MIRAMAR, FL 33025-3005
(954) 962-5734
Mailing address
4000 HOLLYWOOD BLVD STE 300N, HOLLYWOOD, FL 33021-1242
(330) 230-2667
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
08/12/2022
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