Organization
DAVITA MEDICAL FLORIDA, INC.
Active
Organization
DAVITA MEDICAL FLORIDA, INC.
Active
Other names
DaVita Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN EDGINGTON (CFO)
(727) 286-4065
Entity
Organization
Contact information
Practice address
2424 MANATEE AVE W, SUITE 100, BRADENTON, FL 34205-4954
(941) 847-7920
Mailing address
10051 5TH STREET N., ST. PETERSBURG, FL 33702
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME116650
FL
Other
Enumeration date
08/25/2015
Last updated
07/21/2017
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