BRACHE DIALYSIS LLC (NPI# 1871971556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871971556 |
Entity Type | Organization |
Organization Name | BRACHE DIALYSIS LLC |
Other Organization Name | KENNEDY BOULEVARD DIALYSIS |
Practice Address |
2205 W Kennedy Blvd Tampa FL 33606-1536 |
Mailing Address |
5200 Virginia Way L&c Department Brentwood TN 37027-7569 |
Practice Telephone | 8132543638 |
Practice Fax Number | 8132543809 |
Mailing Telephone | 6153204593 |
Mailing Fax Number | 8002935872 |
Enumeration Date | 2015-05-13 |
Last Update Date | 2020-10-26 |
Authorized Official Name | JOHN WINSTEL (CHIEF ACCOUNTING OFFICER) |
Authorized Official Telephone | 2537334501 |
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 | 017606800 | 05 |
Other Name | Type Code |
---|---|
Kennedy Boulevard Dialysis | Doing Business As Name - Organization |
Street Address |
2205 W KENNEDY BLVD |
City | TAMPA |
State | FL |
Zip Code | 33606-1536 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235758749 | Seyed Shayan Ahmad Falasiri | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd. #308, Tampa, FL 33606 | 2020-04-14 |
1174156400 | Jessica Styles | Specialist/Technologist | The University of Tampa, 401 W. Kennedy Blvd, Tampa, FL 33606 | 2020-02-14 |
1295389757 | David Green | Specialist/Technologist | 401 W. Kennedy Blvd Box: I, Tampa, FL 33606 | 2019-08-01 |
1417514720 | Four Winds Counseling LLC | Counselor | 611 West Bay Street, Tampa, FL 33606 | 2019-05-22 |
1699238014 | Azubuogu Charles Anudu | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd., Suite 308 Tampa, Fl 33606, Tampa, FL 33606 | 2019-04-11 |
1508327883 | D'arcy Jocelyn Arden Wainwright | Student in an Organized Health Care Education/Training Program | 17 David Blvd., Suite 308, Tampa, FL 33606 | 2019-03-28 |
1659851772 | Heather Widmer | Counselor | 202 N Howard Ave, Tampa, FL 33606 | 2018-08-17 |
1447737291 | Jonathan T Bell | Marriage & Family Therapist | 425 S. Orleans Ave, Tampa, FL 33606 | 2018-07-24 |
1184157539 | Alexander Lim | Student in an Organized Health Care Education/Training Program | 17 David Blvd, Suite 308, Tampa, FL 33606 | 2017-04-04 |
1760913057 | Melanie Loretta Bradley | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd. Suite 308, University of South Florida, Morsani College of Medicin, Tampa, FL 33606 | 2017-03-27 |
Find all providers in zip 33606 |
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 |
---|---|---|---|---|
1720622574 | Fresenius Medical Care Tampa, LLC | Clinic/Center | 4602 N Armenia Ave Bldg B, Tampa, FL 33603-2626 | 2019-11-05 |
1932677838 | Bayfield Dialysis LLC | Clinic/Center | 6222 Harney Rd, Tampa, FL 33610-5500 | 2018-11-08 |
1437673407 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 5951 Webb Rd, Tampa, FL 33615-3219 | 2017-08-01 |
1952771313 | Starks Dialysis LLC | Clinic/Center | 2301 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607 | 2015-09-29 |
1922477017 | Starks Dialysis, LLC | Clinic/Center | 2301 Martin Luther King Jr Blvd, Tampa, FL 33606 | 2015-09-18 |
1033599766 | Dsi Lutz, LLC | Clinic/Center | 3421 N Lakeview Dr, Tampa, FL 33618-4910 | 2015-06-08 |
1275810905 | Mammoth Dialysis LLC | Clinic/Center | 14358 N Dale Mabry Hwy, Tampa, FL 33618-2018 | 2011-11-09 |
1518196252 | Total Renal Care Inc | Clinic/Center | 10770 N 46th St Ste A100, Tampa, FL 33617-3465 | 2009-07-02 |
1629250857 | Bio Medical Applications | Clinic/Center | 5625 W Waters Ave Ste A, Tampa, FL 33634-1226 | 2007-11-29 |
1245324995 | University of South Florida Dialysis Center | Clinic/Center | 10770 N 46th Street Suite A 100, Tampa, FL 33617 | 2006-10-03 |
Find all providers in TAMPA |
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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.