MELBOURNE KIDNEY CENTER INC (NPI# 1104823731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104823731 |
| Entity Type | Organization |
| Organization Name | MELBOURNE KIDNEY CENTER INC |
| Other Organization Name | HARBOR CITY DIALYSIS |
| Practice Address |
280 N Wickham Rd Melbourne FL 32935-8650 |
| Practice Telephone | 3213085005 |
| Practice Fax Number | 3213085002 |
| Mailing Telephone | 3213085005 |
| Mailing Fax Number | 3213085002 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2010-12-22 |
| Authorized Official Name | MRS. SADALIA BARTMAN GROSS (ADMINISTRATOR) |
| Authorized Official Telephone | 3217240431 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| HARBOR CITY DIALYSIS | Doing Business As Name - Organization |
| Street Address |
280 N WICKHAM RD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-8650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821380593 | Bio-medical Applications of Florida Inc. | Clinic/Center | 2200 W Eau Gallie Blvd Ste 202a, Melbourne, FL 32935-3166 | 2011-05-12 |
| 1891807640 | Brevard County Dialysis, LLC | Clinic/Center | 1355 Palm Bay Rd, Melbourne, FL 32905-3838 | 2006-08-31 |
| 1104893221 | Dva Renal Healthcare, Inc. | Clinic/Center | 2235 S Babcock St, Melbourne, FL 32901 | 2006-03-07 |
| 1578569109 | Central Florida Kidney Centers Inc | Clinic/Center | 14 Suntree Pl, Ste 102, Melbourne, FL 32940-7605 | 2005-06-28 |
| 1245236876 | Central Florida Kidney Centers Inc | Clinic/Center | 1400 S Apollo Blvd, Melbourne, FL 32901-3145 | 2005-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496104 | Kidney Care Center of Winter Haven LLC | Clinic/Center | 1107 3rd St Sw Ste 9, Winter Haven, FL 33880-3912 | 2020-10-27 |
| 1538773411 | 5072020, LLC | Clinic/Center | 2675 Winkler Ave Ste 130, Fort Myers, FL 33901-9362 | 2020-09-08 |
| 1750992814 | Swain Dialysis Renal Center | Clinic/Center | 1923 Nw 43rd St, Miami, FL 33142-4777 | 2020-08-12 |
| 1396355525 | Kidney Partners Coral Gables LLC | Clinic/Center | 835 Sw 37th Ave, Miami, FL 33135-4289 | 2020-08-03 |
| 1427668870 | Dialysis Spa, LLC | Clinic/Center | 2040 Ne 163rd St Ste 206, North Miami Beach, FL 33162-4953 | 2020-07-31 |
| 1285250522 | Fresenius Medical Care Casselberry, LLC | Clinic/Center | 775 Gateway Dr Ste 1010, Altamonte Springs, FL 32714-1524 | 2020-06-23 |
| 1992321244 | Fresenius Medical Care Casselberry, LLC | Clinic/Center | 750 Northlake Blvd Ste 1024, Altamonte Springs, FL 32701-6745 | 2020-06-23 |
| 1023630886 | Fresenius Medical Care Apollo Beach, LLC | Clinic/Center | 3002 E College Ave, Ruskin, FL 33570-5220 | 2020-05-14 |
| 1124640263 | Arc Dialysis Westchester LLC | Clinic/Center | 11501 Sw 40th St Ste 100, Miami, FL 33165-3313 | 2020-05-12 |
| 1487274734 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 2777 University Blvd W Ste 39, Jacksonville, FL 32217-2143 | 2020-04-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MELBOURNE KIDNEY CENTER INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.