Organization
PEMBROKE PINES ARTIFICIAL KIDNEY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKI L BURRIER RN, MBA (DIRECTOR/VICE-PRESIDENT)
(954) 474-7701
Entity
Organization
Contact information
Practice address
12145 PEMBROKE RD, PEMBROKE PINES, FL 33025-1727
(954) 435-2553
(954) 435-3361
Mailing address
7061 CYPRESS RD, SUITE 104, PLANTATION, FL 33317-2243
(954) 474-7701
(954) 474-7702
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
—
210408300
—
FL
01
—
V3Y
BC/BS PROVIDER NO
FL
Enumeration date
01/19/2006
Last updated
10/20/2009
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