Organization
KIDNEYSPA EAST ATLANTA DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN M CUELLAR M.D. (CEO)
(305) 329-2900
Entity
Organization
Contact information
Practice address
2375 METROPOLITAN PKWY SW, ATLANTA, GA 30315-6223
(305) 329-2900
Mailing address
219 NW 12TH AVE APT 508, MIAMI, FL 33128-2206
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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