Organization
KIDNEYSPA TAMPA BAY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN M CUELLAR (CEO)
(305) 548-4000
Entity
Organization
Contact information
Practice address
508 S HABANA AVE STE 270, TAMPA, FL 33609-4198
(305) 548-4000
(305) 329-2901
Mailing address
219 NW 12TH AVE APT 508, MIAMI, FL 33128-2206
(305) 548-4000
(305) 329-2901
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/30/2023
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