Organization
NEW SMYRNA BEACH DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN J. MCDONOUGH (COO)
(978) 922-3080
Entity
Organization
Contact information
Practice address
821 STATE ROAD 44, NEW SMYRNA BEACH, FL 32168-7271
(386) 409-8855
(386) 409-8755
Mailing address
821 STATE ROAD 44, NEW SMYRNA BEACH, FL 32168-7271
(386) 409-8855
(386) 409-8755
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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