WESTON DIALYSIS CENTER LLC (NPI# 1699743930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699743930 |
| Entity Type | Organization |
| Organization Name | WESTON DIALYSIS CENTER LLC |
| Other Organization Name | WESTON DIALYSIS CENTER |
| Practice Address |
2685 Executive Park Dr Ste 1 Weston FL 33331-3651 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9543891290 |
| Practice Fax Number | 9543848207 |
| Mailing Telephone | 6153204593 |
| Mailing Fax Number | 8002935872 |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2019-06-10 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER, TREASURER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 8913447 00 | 05 |
| Other Name | Type Code |
|---|---|
| Weston Dialysis Center | Doing Business As Name - Organization |
| Street Address |
2685 EXECUTIVE PARK DR STE 1 |
| City | WESTON |
| State | FL |
| Zip Code | 33331-3651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568073823 | Wesley Roland Innocent Jr. | Physical Medicine & Rehabilitation | 2685 Executive Park Dr, Weston, FL 33331-3651 | 2020-08-11 |
| 1962029991 | Jessica Weaver | Speech-Language Pathologist | 2685 Executive Park Dr, Weston, FL 33331-3651 | 2020-06-25 |
| 1508496704 | David E Rubell | Occupational Therapy Assistant | 2685 Executive Park Dr, Weston, FL 33331-3651 | 2020-01-16 |
| 1710432489 | Kenia I Lewis | Occupational Therapist | 2685 Executive Park Dr, Weston, FL 33331-3651 | 2016-08-23 |
| 1346627288 | Cassandra Michelle Gubnitsky | Speech-Language Pathologist | 2685 Executive Park Dr, Weston, FL 33331-3651 | 2015-04-29 |
| 1205239621 | Deanna Smith | Speech-Language Pathologist | 2685 Executive Park Dr, Weston, FL 33331-3651 | 2014-09-30 |
| 1962756692 | Rebecca Alexandra Casas | Occupational Therapist | 2685 Executive Park Dr, Suite 5, Weston, FL 33331-3651 | 2012-11-02 |
| 1982995668 | Cynthia Ann Dominguez | Speech-Language Pathologist | 2685 Executive Park Dr, Suite 4, Weston, FL 33331-3651 | 2011-04-28 |
| 1942512652 | Kimberly Tice | Speech-Language Pathologist | 2685 Executive Park Dr, Suite 5, Weston, FL 33331-3651 | 2010-07-10 |
| 1699929752 | Jaime Antonio Correa | Occupational Therapist | 2685 Executive Park Dr, Suite 4, Weston, FL 33331-3651 | 2008-11-15 |
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|---|---|---|---|---|
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| 1689212854 | Rumman Ahmed Khalid | Student in an Organized Health Care Education/Training Program | 16129 Opal Creek Drive, Weston, FL 33331 | 2019-12-18 |
| 1275015505 | B & B Monitoring LLC | Emergency Response System Companies | 4474 Weston Road, Suite 3, Ft Lauderdale, FL 33331 | 2018-09-04 |
| 1609367747 | Gerardo Minsal, Md Pa | Internal Medicine | 16720 Sapphire Springs, Weston, FL 33331 | 2018-05-24 |
| 1447747258 | Mario Ricardo Pimentel | Student in an Organized Health Care Education/Training Program | 2950 Cleveland Clinic Boulevard, Weston, FL 33331 | 2018-04-17 |
| 1619471547 | Farida Makubelly Law | Nurse Practitioner | 3100 Cleveland Clinic, Weston, FL 33331 | 2018-03-23 |
| 1942709902 | John Kross Pharmacy #2, Inc | Pharmacy | 16618 Sheridan St, Fort Lauderdale, FL 33331 | 2018-02-06 |
| 1922512342 | Luisa Fernanda Quevedo | Occupational Therapy Assistant | 4350 Mahogany Ridge Dr, Weston, FL 33331 | 2017-11-21 |
| 1144752551 | Therese Youssef Andraos | Student in an Organized Health Care Education/Training Program | 2950 Cleveland Clinic Blvd., Weston, FL 33331 | 2017-04-03 |
| 1255720843 | Horse and Petting Pal Interaction, Inc. | Counselor | 17800 Sw 52 Ct, Southwest Ranches, FL 33331 | 2015-01-20 |
| Find all providers in zip 33331 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 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 |
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| 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.