Organization
GULF COAST KIDNEY CENTER INC
Active
Other names
Physicians Dialysis Hudson
Organization subpart
No
Provider details
NPI number
Authorized official
ARTURO FERNANDEZ (VICE PRESIDENT)
(305) 651-3261
Entity
Organization
Contact information
Practice address
14153 YOSEMITE DR, SUITE 102, HUDSON, FL 34667-8060
(727) 862-0603
(727) 862-4939
Mailing address
19559 N E 10 AVENUE, N MIAMI BEACH, FL 33179-3501
(305) 651-3261
(305) 651-2961
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
—
209147001
—
FL
Enumeration date
07/05/2006
Last updated
05/03/2010
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