Organization
SOUTHWEST FLORIDA DIALYSIS CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCE A PHILLIPS RN (ADMINISTRATOR)
(941) 747-5500
Entity
Organization
Contact information
Practice address
520 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 747-5500
(941) 748-7879
Mailing address
520 MANATEE AVE E, BRADENTON, FL 34208-1146
(941) 747-5500
(941) 748-7879
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892804500
—
FL
Enumeration date
06/06/2007
Last updated
07/07/2008
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