Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
3129 HENDRICKS AVE, JACKSONVILLE, FL 32207-4217
(904) 398-8266
(904) 396-4803
Mailing address
3129 HENDRICKS AVE, JACKSONVILLE, FL 32207-4217
(904) 398-8266
(904) 396-4803
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003852100
—
FL
05
—
003852101
—
FL
05
—
003852102
—
FL
Enumeration date
03/07/2011
Last updated
10/04/2023
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