RENAL CARE GROUP OF THE SOUTHEAST INC (NPI# 1356453195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356453195 |
| Entity Type | Organization |
| Organization Name | RENAL CARE GROUP OF THE SOUTHEAST INC |
| Other Organization Name | FRESENIUS MEDICAL CARE CORDOVA |
| Practice Address |
5401 Corporate Woods Dr Suite 850 Pensacola FL 32504-8984 |
| Practice Telephone | 8504848646 |
| Practice Fax Number | 8504849011 |
| Mailing Telephone | 8504848646 |
| Mailing Fax Number | 8504849011 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-05-04 |
| Authorized Official Name | JAMES JOSEPH DIVITO (VICE PRESIDENT) |
| Authorized Official Telephone | 7816999000 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 890028100 | 05 |
| Other Name | Type Code |
|---|---|
| Fresenius Medical Care Cordova | Doing Business As Name - Organization |
| Renal Care Group - Cordova | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003928847 | Renal Care Group of The Southeast Inc | Clinic/Center | 1208 W Bypass, Andalusia, AL 36420-5204 | 2006-08-31 |
| 1801908645 | Renal Care Group of The Southeast Inc | Clinic/Center | 223 E Redstone Ave, Crestview, FL 32539-5373 | 2006-08-31 |
| 1619089455 | Renal Care Group of The Southeast Inc | Clinic/Center | 1040 E Nine Mile Rd, Pensacola, FL 32514-1649 | 2006-08-31 |
| 1265544001 | Renal Care Group of The Southeast Inc | Clinic/Center | 5151 N 9th Ave, Depaul Bldg. 3rd Fl., Pensacola, FL 32504-8721 | 2006-08-31 |
| 1316059009 | Renal Care Group of The Southeast Inc | Clinic/Center | 5934 Berryhill Medical Park Dr, Suite 2, Milton, FL 32570 | 2006-08-31 |
| Street Address |
5401 CORPORATE WOODS DR SUITE 850 |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-8984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699750083 | Andrea Mraz Nelson | Physical Therapist | 5401 Corporate Woods Dr, Suite 300, Pensacola, FL 32504-8984 | 2005-12-08 |
| 1568589588 | Louie Watkins IIi | Physical Therapist | 5401 Corporate Woods Dr, Suite 300, Pensacola, FL 32504-8984 | 2007-03-23 |
| 1245273242 | Pensacola Nephrology Pa | Specialist | 5401 Corporate Woods Dr, Suite 850, Pensacola, FL 32504-8984 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978393 | Quinyatta Stride | Behavior Technician | 2511 Creighton Rd., Pensacola, FL 32504 | 2020-10-06 |
| 1962017657 | Pt Solutions of Pensacola LLC | Occupational Therapist | 2114 Creighton Rd, Ste C, Pensacola, FL 32504 | 2020-09-10 |
| 1982226742 | Elevate Behavioral Solutions | Behavioral Analyst | 4045 Renoir St, Pensacola, FL 32504 | 2020-05-14 |
| 1760021349 | Veteran Evaluations of Florida | Internal Medicine | 2411 Executive Plaza Drive, Suite A, Pensacola, FL 32504 | 2019-12-31 |
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1184261158 | Claire Ann Letendre | Audiologist | 5153 N 9th Ave Pediatric Off Building, Pensacola, FL 32504 | 2019-12-09 |
| 1083275101 | Benjamin Mcmillon | Chiropractor | 2629 Creighton Road, Suite 1, Pensacola, FL 32504 | 2019-06-28 |
| 1407342595 | Faryal Munir | Student in an Organized Health Care Education/Training Program | Uf Pediatric Residency 5151 North 9th Ave, 6th Floor Nemours, Pensacola, FL 32504 | 2018-07-02 |
| 1497252050 | Sibyl Tenille Page | Nurse Practitioner | 5147 N 9th Ave Ste 322, Pensacola, FL 32504 | 2018-04-10 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| Find all providers in zip 32504 | ||||
| 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 |
|---|---|---|---|---|
| 1326566084 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 5476 Mobile Hwy, Pensacola, FL 32526-2104 | 2017-09-01 |
| 1215287115 | Reef Dialysis LLC | Clinic/Center | 812 Creighton Rd, Pensacola, FL 32504-7028 | 2012-09-18 |
| 1639445463 | Total Renal Care Inc | Clinic/Center | 700 E Cervantes St, Ste A, Pensacola, FL 32501-3489 | 2012-03-27 |
| 1851415228 | West Pensacola Dialysis LLC | Clinic/Center | 598 N Fairfield Dr, Pensacola, FL 32506-4320 | 2007-03-19 |
| 1992817738 | Renal Care Group of The Southeast, Inc. | Clinic/Center | 1305 W Moreno St, Pensacola, FL 32501-2321 | 2006-08-31 |
| 1619089455 | Renal Care Group of The Southeast Inc | Clinic/Center | 1040 E Nine Mile Rd, Pensacola, FL 32514-1649 | 2006-08-31 |
| 1619089463 | Rcg Pensacola, LLC | Clinic/Center | 2940 N Blue Angel Pkwy, Pensacola, FL 32506-2925 | 2006-08-31 |
| 1326366329 | Total Renal Care Inc | Clinic/Center | 598 N Fairfield Dr, Ste 100, Pensacola, FL 32506-4320 | 2010-05-14 |
| 1265544001 | Renal Care Group of The Southeast Inc | Clinic/Center | 5151 N 9th Ave, Depaul Bldg. 3rd Fl., Pensacola, FL 32504-8721 | 2006-08-31 |
| 1336117670 | Renal Treatment Centers Southeast Lp | Clinic/Center | 8333 N Davis Hwy, 1st Floor Attn Dialysis Room, Pensacola, FL 32514 | 2006-03-11 |
| Find all providers in PENSACOLA | ||||
Please comment or provide details below to improve the information on RENAL CARE GROUP OF THE SOUTHEAST 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.