Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Orlando Southwest Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
6925 LAKE ELLENOR DR, STE 650, ORLANDO, FL 32809-4670
(407) 852-1751
(407) 852-1748
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
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
—
890573800
—
FL
Enumeration date
03/10/2006
Last updated
09/25/2025
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