Organization
EAST FT LAUDERDALE LLC
Active
Other names
East Ft Lauderdale Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1301 S ANDREWS AVE, STE 101, FT LAUDERDALE, FL 33316-1823
(954) 761-1273
(954) 467-0384
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
—
890219400
—
FL
Enumeration date
04/26/2006
Last updated
01/28/2024
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