Organization
SUNCOAST DIALYSIS CENTER IMC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER LAWRENCE WALSH JR. (PRESIDENT)
(813) 972-3722
Entity
Organization
Contact information
Practice address
3500 E FLETCHER AVE, SUITE 122, TAMPA, FL 33613-4708
(813) 972-3722
(813) 972-0717
Mailing address
3500 E FLETCHER AVE, SUITE 122, TAMPA, FL 33613-4708
(813) 972-3722
(813) 972-0717
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
FL
Other
Enumeration date
07/28/2006
Last updated
08/22/2020
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