Organization
HAVERHILLS DIALYSIS, LLC
Active
Parent organization
DAVITA INC
Other names
Cocoa Beach Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(303) 405-5117
Entity
Organization
Contact information
Practice address
2300 STATE ROAD 524 STE 106, COCOA, FL 32926-5894
(321) 482-5609
(321) 482-5868
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
(615) 320-4283
(800) 320-3933
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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