Organization
INTEGRA DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOCORRO MIRYAM MATHEWS APRN (ADMINISTRATOR)
(954) 274-6045
Entity
Organization
Contact information
Practice address
1490 W 49TH PL, HIALEAH, FL 33012-3148
(954) 274-6045
Mailing address
6100 SW 183RD WAY, SOUTHWEST RANCHES, FL 33331-1640
(954) 274-6045
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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