Organization
ARA-DAYTONA BEACH DIALYSIS LLC
Active
Other names
Dialysis Care Center of Daytona
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARI COUSINS (SR. VP OF CLINICAL & REGULATORY)
(978) 922-3080
Entity
Organization
Contact information
Practice address
720 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-1604
(386) 947-9872
(386) 947-9873
Mailing address
720 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-1604
(386) 947-9872
(386) 947-9873
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891326900
—
FL
Enumeration date
08/31/2006
Last updated
03/10/2020
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