DVA RENAL HEALTHCARE INC (NPI# 1962470468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962470468 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | ORLANDO EAST DIALYSIS |
| Practice Address |
11616 Lake Underhill Rd Ste 206 Orlando FL 32825-4466 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 4073841175 |
| Practice Fax Number | 4073841421 |
| Mailing Telephone | 6153204593 |
| Mailing Fax Number | 8002935872 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-07-12 |
| 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 | 890571100 | 05 |
| Other Name | Type Code |
|---|---|
| Orlando East Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629415609 | Dva Renal Healthcare Inc | Clinic/Center | 300 B 22nd St South, Birmingham, AL 35233-2209 | 2013-05-30 |
| 1164728408 | Dva Renal Healthcare Inc | Clinic/Center | 415 W Nc Hwy 54, Durham, NC 27713-7516 | 2011-02-03 |
| 1295983245 | Dva Renal Healthcare Inc | Clinic/Center | 1919 Charlotte Ave Ste 200, Nashville, TN 37203-2245 | 2008-09-03 |
| 1811171440 | Dva Renal Healthcare Inc | Clinic/Center | 300 W Broadway Ste 150, Council Bluffs, IA 51503-9077 | 2007-12-18 |
| 1881623585 | Dva Renal Healthcare Inc | Clinic/Center | 271 King St, Perth Amboy, NJ 08861-4488 | 2006-07-03 |
| 1164451852 | Dva Renal Healthcare Inc | Clinic/Center | 262 Texas Rd, Ste 101, Old Bridge, NJ 08857-4008 | 2006-07-03 |
| 1912936618 | Dva Renal Healthcare Inc | Clinic/Center | 1200 Randolph Rd, Muhlenburg Campus, Plainfield, NJ 07060-3361 | 2006-07-03 |
| 1346270782 | Dva Renal Healthcare Inc | Clinic/Center | 230 Van Sciver Pkwy, Willingboro, NJ 08046-1131 | 2006-07-03 |
| 1548299381 | Dva Renal Healthcare Inc | Clinic/Center | 29 Meridian Rd, Edison, NJ 08820-2823 | 2006-07-02 |
| 1548299373 | Dva Renal Healthcare Inc | Clinic/Center | 14-20 Prospect St, East Orange, NJ 07017-2238 | 2006-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DVA Renal Healthcare Inc. | 2000 16th St, Jld/secgovfin, Denver, Colorado 80202-5117 |
| Street Address |
11616 LAKE UNDERHILL RD STE 206 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32825-4466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912302431 | Michael Herringshaw | Nurse Practitioner | 11616 Lake Underhill Rd, Ste 215, Orlando, FL 32825 | 2014-10-27 |
| 1023431863 | Sandra Quintero | Specialist | 11616 Lake Underhill Rd, Suite 215, Orlando, FL 32825-4463 | 2014-01-30 |
| 1447689203 | Center for Individualized Medicine and Age Management, Inc | Family Medicine | 11616 Lake Underhill Rd, Ste 205, Orlando, FL 32825-4463 | 2013-11-02 |
| 1174958771 | Donna Lynn Jones | Registered Nurse | 11616 Lake Underhill Rd, Orlando, FL 32825-4463 | 2013-09-13 |
| 1457695520 | Joann Mordenti | Physician Assistant | 11616 Lake Underhill Rd, Suite 215, Orlando, FL 32825-4463 | 2012-11-15 |
| 1982729109 | Matthew Andrew Shlapack | Internal Medicine | 11616 Lake Underhill Rd, Orlando, FL 32825-4463 | 2007-03-20 |
| 1093735615 | Mildred Donis Silva | Family Medicine | 11616 Lake Underhill Rd, Suite 205, Orlando, FL 32825-4463 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881255404 | Planes Dental East Orlando | Clinic/Center | 275 S Chickasaw Trail, Suite 2, Orlando, FL 32825 | 2019-06-25 |
| 1649837550 | Jessica Rivera | Social Worker | 10600 Bloomfield Drive, Apt 918, Orlando, FL 32825 | 2019-05-27 |
| 1326526708 | Total Family Care LLC | Family Medicine | 106 North Dean Road, Suite 1, Orlando, FL 32825 | 2018-07-30 |
| 1285121772 | Neurological Health Associates, L.L.C. | Psychiatry & Neurology | 11602 Lake Underhill Rd., Suite 104, Orlando, FL 32825 | 2018-04-19 |
| 1336636075 | Vijaya Laxmi Telu | Nurse Practitioner | 100 North Dean Rd Suite 101, Orlando, FL 32825 | 2018-04-18 |
| 1740795053 | Anna Louise Morris | Specialist/Technologist | 10719 Fairhaven Way, Orlando, FL 32825 | 2017-12-08 |
| 1568973352 | Darrenn G Cadet | Behavior Technician | 11121 Tortuga Bnd, Orlando, FL 32825 | 2017-10-19 |
| 1265942072 | Raquel B Saliba | Physical Therapist | 250 South Chickasaw Trail, Orlando, FL 32825 | 2017-10-06 |
| 1528585890 | Vreny Tatyana Gonzalez-casas | Behavior Technician | 3206 Mattson Dr, Orlando, FL 32825 | 2017-08-27 |
| 1184147803 | Alexandra Grace Mcmanus | Social Worker | 11258 Point Sylvan Circle, Orlando, FL 32825 | 2017-07-25 |
| Find all providers in zip 32825 | ||||
| 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 |
|---|---|---|---|---|
| 1720559198 | Caring Heart Metro West Dialysis LLC | Clinic/Center | 1743 Park Center Dr Ste 300, Orlando, FL 32835-7621 | 2018-12-11 |
| 1619450988 | Total Renal Care Inc | Clinic/Center | 828 Mercy Dr, Orlando, FL 32808-7820 | 2018-09-12 |
| 1700369089 | Total Renal Care Inc | Clinic/Center | 7960 Forest City Rd Ste 105, Orlando, FL 32810-2938 | 2018-09-12 |
| 1831690924 | Lourdes Dialysis LLC | Clinic/Center | 8259 Clarcona Ocoee Rd, Orlando, FL 32818-1228 | 2018-02-23 |
| 1861933699 | West Orange Orlando Dialysis Center LLC | Clinic/Center | 828 Mercy Dr Ste 2, Orlando, FL 32808-7820 | 2017-03-13 |
| 1295274595 | Lourdes Dialysis LLC | Clinic/Center | 12001 Science Dr Ste 110, Orlando, FL 32826-2913 | 2017-02-20 |
| 1689126757 | South Central Florida Dialysis Partners LLC | Clinic/Center | 5778 S Semoran Blvd Ste A, Orlando, FL 32822-4819 | 2016-10-25 |
| 1013468438 | Total Renal Care Inc | Clinic/Center | 5778 S Semoran Blvd, Ste A, Orlando, FL 32822-4819 | 2016-10-20 |
| 1942679667 | Central Florida Kidney Centers Inc | Clinic/Center | 401 S Chickasaw Trl, Orlando, FL 32825-7803 | 2015-09-23 |
| 1396124905 | West Orange Maitland Dialysis Center LLC | Clinic/Center | 7960 Forest City Rd, Suite 105, Orlando, FL 32810-2938 | 2015-05-28 |
| Find all providers in ORLANDO | ||||
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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.