Organization
PURE LIFE RENAL OF STOUGHTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF FERNANDEZ (CHIEF FINANCIAL OFFICER)
(954) 962-5733
Entity
Organization
Contact information
Practice address
907 SUMNER ST, MEDICAL OFFICE BUILDING M107, STOUGHTON, MA 02072
(781) 341-8550
Mailing address
4000 HOLLYWOOD BLVD STE 300N, HOLLYWOOD, FL 33021-1242
(954) 962-5733
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2016
Last updated
04/06/2026
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