Organization
UNIVERSITY OF SOUTH FLORIDA DIALYSIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IZZY HERNANDEZ (UNIT ADMINISTRATOR)
(813) 632-7918
Entity
Organization
Contact information
Practice address
10770 N 46TH STREET SUITE A 100, TAMPA, FL 33617
(813) 632-7918
(813) 632-7941
Mailing address
10770 N 46TH STREET SUITE A 100, TAMPA, FL 33617
(813) 632-7918
(813) 632-7941
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
—
030279101
—
FL
Enumeration date
10/03/2006
Last updated
06/17/2008
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