Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Daytona Beach 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
578 HEALTH BLVD, DAYTONA BEACH, FL 32114-1492
(386) 258-7322
(386) 258-0191
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
—
200516600
—
FL
05
—
887573
—
AZ
Enumeration date
03/10/2006
Last updated
03/17/2026
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