Organization
WEST ORANGE PALM COAST DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKIN AWOSIKA (CFO)
(407) 927-5873
Entity
Organization
Contact information
Practice address
57 TOWN CT STE 118, PALM COAST, FL 32164-2425
(407) 297-8408
Mailing address
1210 E PLANT ST STE 120, WINTER GARDEN, FL 34787-2995
(407) 297-8408
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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