Organization
JOHNSON DIALYSIS CENTER OF DAVIE FLORIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH CARRASCO (ADMINISTRATOR)
(954) 962-9640
Entity
Organization
Contact information
Practice address
3105 NORTH UNIVERSITY DRIVE, DAVIE, FL 33024
(954) 962-9640
(954) 962-9641
Mailing address
3105 N UNIVERSITY DR, SUITE 3, HOLLYWOOD, FL 33024-2222
(954) 962-9640
(954) 962-9641
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2011
Last updated
08/11/2020
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