Organization
RENAL TREATMENT CENTERS SOUTHEAST LP
Active
Other names
Lake Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
211 N 1ST ST, LEESBURG, FL 34748-5150
(352) 326-8100
(352) 326-8307
Mailing address
5200 VIRGINIA WAY, L&C DEPT., BRENTWOOD, TN 37027-7569
(615) 341-6475
(877) 699-0751
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
—
890078700
—
FL
Enumeration date
03/03/2006
Last updated
03/13/2015
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