BREVARD COUNTY DIALYSIS, LLC (NPI# 1891807640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891807640 |
| Entity Type | Organization |
| Organization Name | BREVARD COUNTY DIALYSIS, LLC |
| Other Organization Name | RENAL CARE GROUP BREVARD |
| Practice Address |
1355 Palm Bay Rd Melbourne FL 32905-3838 |
| Practice Telephone | 3217689801 |
| Practice Fax Number | 3217689826 |
| Mailing Telephone | 3217689801 |
| Mailing Fax Number | 3217689826 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-05-10 |
| Authorized Official Name | MR. MARK R FAWCETT (SVP & TREASURER) |
| 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 |
| Other Name | Type Code |
|---|---|
| RENAL CARE GROUP BREVARD | Doing Business As Name - Organization |
| Street Address |
1355 PALM BAY RD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32905-3838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460928 | Lavell Woodard Jr. | Counselor | 4206 Pinewood Dr Ne, Palm Bay, FL 32905 | 2020-05-29 |
| 1548735699 | Aaron J Milton | Counselor | 1420 Sportsman Lane Ne, Palm Bay, FL 32905 | 2018-10-04 |
| 1871070417 | The Brevard Health Alliance Inc | Clinic/Center | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-26 |
| 1699266361 | Coastal Visioncare LLC | Optometrist | 2186 Harris Ave Ne Ste 1, Palm Bay, FL 32905 | 2018-05-29 |
| 1184173981 | Jean Elyse Gautreaux | Social Worker | 2475 Palm Bay Rd Ne, Suite 130 #4, Palm Bay, FL 32905 | 2016-09-22 |
| 1174901607 | Reginald Shannon Seecharan | Developmental Therapist | 700 James Cir Ne, Palm Bay, FL 32905 | 2015-05-17 |
| 1881091254 | Courtney Taft | Physical Therapy Assistant | 1155 Malabar Road, Suite 1, Palm Bay, FL 32905 | 2014-12-01 |
| 1548513310 | Juda Marie Decara | Counselor | 4690 Lipscomb St Se, Suite 6c, Palm Bay, FL 32905 | 2012-10-18 |
| 1326308313 | Mohammad Idrees Md, P.a. | Internal Medicine | 1454 Belaire Lane N.e., Palm Bay, FL 32905 | 2012-05-23 |
| 1265704548 | Atm Amin Dds LLC | Dentist | 4620 Lipscomb St Ne, Suite 2, Palm Bay, FL 32905 | 2012-02-02 |
| Find all providers in zip 32905 | ||||
| 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 |
| 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 |
| 1104823731 | Melbourne Kidney Center Inc | Clinic/Center | 280 N Wickham Rd, Melbourne, FL 32935-8650 | 2005-06-28 |
| 1245236876 | Central Florida Kidney Centers Inc | Clinic/Center | 1400 S Apollo Blvd, Melbourne, FL 32901-3145 | 2005-06-28 |
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|---|---|---|---|---|
| 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.