Organization
ST PETERSBURG KIDNEY CARE LLC
Active
Other names
ST. PETERSBURG KIDNEY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
800 3RD AVE S, WEBB PLAZA, ST PETERSBURG, FL 33701-4010
(727) 821-3201
(727) 821-3140
Mailing address
800 3RD AVE S, WEBB PLAZA, ST PETERSBURG, FL 33701-4010
(727) 821-3201
(727) 821-3140
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
—
006736000
—
FL
Enumeration date
03/26/2012
Last updated
01/14/2023
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