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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