Organization
DAVITA MEDICAL FLORIDA, INC.
Active
Other names
DaVita Medical Group, Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES HILGER (CHIEF ACCOUNTING OFFICER)
(253) 973-0777
Entity
Organization
Contact information
Practice address
4757 US HIGHWAY 19 STE A, NEW PORT RICHEY, FL 34652-4945
(727) 849-9373
(727) 815-1203
Mailing address
10051 5TH STREET NORTH, ST. PETERSBURG, FL 33702-2299
(727) 824-0780
(727) 828-2321
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336S0011X
Specialty Pharmacy
Primary
18603
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133637
PK
—
Enumeration date
02/03/2012
Last updated
05/10/2017
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