Organization
ST PETERSBURG KIDNEY CARE SOUTH LLC
Active
Other names
St. Petersburg Kidney Center South
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
4050 34TH STREET SOUTH, ST PETERSBURG, FL 33711-4350
(727) 867-1279
(727) 867-1280
Mailing address
4050 34TH STREET SOUTH, ST PETERSBURG, FL 33711-4350
(727) 867-1279
(727) 867-1280
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
—
014094000
—
FL
Enumeration date
04/29/2014
Last updated
01/14/2023
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