Organization
KIDNEYSPA HIALEAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN M CUELLAR MD (CEO)
(305) 329-2900
Entity
Organization
Contact information
Practice address
4286 PALM AVE, HIALEAH, FL 33012-4454
(305) 329-2900
(305) 428-5698
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
09/21/2022
Last updated
10/16/2023
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