Organization
WILLSTONE DIALYSIS, LLC
Active
Parent organization
DAVITA INC
Other names
Fishhawk Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVITA INC
Authorized official
SAMUEL WEY (VP, LICENSURE AND CERTIFICATION)
(615) 341-6691
Entity
Organization
Contact information
Practice address
16625 FISHHAWK BLVD, LITHIA, FL 33547
(941) 392-2995
(863) 341-6287
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
(615) 320-4283
(800) 320-3933
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2024
Last updated
10/23/2024
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