KIDNEY LIFE INCORPORATED (NPI# 1760523294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760523294 |
| Entity Type | Organization |
| Organization Name | KIDNEY LIFE INCORPORATED |
| Other Organization Name | SEMINOLE DIALYSIS CENTER |
| Practice Address |
10755 Park Blvd Suite B Seminole FL 33772-5420 |
| Mailing Address |
Po Box 47069 St Petersburg FL 33743-7069 |
| Practice Telephone | 7273935551 |
| Practice Fax Number | 7273981971 |
| Mailing Telephone | 7275896550 |
| Mailing Fax Number | 7278985317 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2012-04-23 |
| Authorized Official Name | MS. JOSSETTE S MALTI (CEO PRESIDENT) |
| Authorized Official Telephone | 7278965500 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS FL | V19 | 01 |
| FL | 200573500 | 05 |
| Other Name | Type Code |
|---|---|
| Seminole Dialysis Center | Doing Business As Name - Organization |
| Street Address |
10755 PARK BLVD SUITE B |
| City | SEMINOLE |
| State | FL |
| Zip Code | 33772-5420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710193511 | Vision Specialty Associates, P.a. | Optometrist | 10755 Park Blvd, Seminole, FL 33772-5420 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245765205 | Capstone Eye Care Group of Florida LLC | Eyewear Supplier (Equipment, not the service) | 7855 113th St Bldg P-2, Suite A, Seminole, FL 33772 | 2017-04-27 |
| 1922453067 | Donna Malkovich | Nurse Practitioner | 11925 Mandarin Ct, Seminole, FL 33772 | 2016-04-26 |
| 1518259209 | Dorca N. May | Nurse's Aide | 11428 - 63 Ave N, Seminole, FL 33772 | 2011-05-12 |
| 1467753681 | Anthony J. Auletta, Jr. D.m.d., Pa | Dentist | 8277 113th Street N, Seminole, FL 33772 | 2010-11-04 |
| 1346559481 | Tiffany Jane Marie Bishop | Physical Therapist | 11224 Park Blvd., N, Cora Rehabilitation, Seminole, FL 33772 | 2010-10-06 |
| 1235442997 | Cynthia Renee Bouchard | Student in an Organized Health Care Education/Training Program | 9200 113th St. N., Seminole, FL 33772 | 2010-07-22 |
| 1851603591 | William Daily | Dentist | 9200 113th St N, Seminole, FL 33772 | 2010-07-10 |
| 1427370295 | Teresa Ann Skinner | Counselor | 7130 Seminole Blvd., Seminole Professional Centre, Seminole, FL 33772 | 2010-02-22 |
| 1922257120 | Jennifer Henkel Johnson | Dentist | 9951 Seminole Blvd, Seminole, FL 33772 | 2008-09-11 |
| 1528233970 | Joann Carol Horianopoulos | Physical Therapy Assistant | 7388 121st Way North, Seminole, FL 33772 | 2008-04-28 |
| Find all providers in zip 33772 | ||||
| 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 |
|---|---|---|---|---|
| 1558800235 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 6450 Seminole Blvd, Seminole, FL 33772-6339 | 2017-02-15 |
| 1215381553 | Bronson Dialysis LLC | Clinic/Center | 10799 Park Blvd, Seminole, FL 33772-5420 | 2016-04-22 |
| 1558669978 | Sng - Seminole Dialysis Center Lp | Clinic/Center | 12581 Ns 3540, Seminole, OK 74868-5879 | 2011-03-09 |
| 1518034032 | Dialysis Specialists of Seminole Oklahoma, LLC | Clinic/Center | 12581 Ns 3540 Cr, Seminole, OK 74868-9789 | 2006-11-29 |
| 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 | ||||
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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.