Organization
KIDNEYSPA AT BIRD ROAD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN MAURICIO CUELLAR MD (CEO)
(305) 329-2900
Entity
Organization
Contact information
Practice address
11501 SW 40TH ST STE 101, MIAMI, FL 33165-3313
(305) 329-2900
Mailing address
219 NW 12TH AVE APT 508, MIAMI, FL 33128-2206
(305) 329-2900
(305) 329-2901
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
10/27/2023
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