PRIME DIALYSIS, LLC (NPI# 1063941565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063941565 |
| Entity Type | Organization |
| Organization Name | PRIME DIALYSIS, LLC |
| Practice Address |
12200 West Colonial Drive Suite 102 Winter Garden FL 34787 |
| Mailing Address |
100 East Sample Road Suite 220 Pompano Beach FL 33064 |
| Practice Telephone | 9547817741 |
| Practice Fax Number | 8883498679 |
| Mailing Telephone | 9547817741 |
| Mailing Fax Number | 8883498679 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Authorized Official Name | MS. MIMI BARRERA (MANAGING MEMBER) |
| Authorized Official Telephone | 3057788277 |
| 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 |
FL | Ambulatory Health Care Facilities |
| Street Address |
12200 WEST COLONIAL DRIVE SUITE 102 |
| City | WINTER GARDEN |
| State | FL |
| Zip Code | 34787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1770196131 | Hamlin Eye Care, LLC | Optometrist | 15820 Shaddock Drive, Suite 150, Winter Garden, FL 34787 | 2020-08-26 |
| 1710501879 | Hz Surgery Center LLC | Clinic/Center | 17085 Porter Road, Suite 110, Winter Garden, FL 34787 | 2020-06-04 |
| 1235759416 | Callie Rebecca Alt | Student in an Organized Health Care Education/Training Program | 2200 Fowler Grove Blvd, Suite 220, Winter Garden, FL 34787 | 2020-04-17 |
| 1992345102 | Advn Dental Partners Pa | Dentist | 516 S. Dillard Street, Winter Garden, FL 34787 | 2020-01-15 |
| 1942851225 | Sara Walker | Physical Therapist | 213 S Dillard Street, Suite 320c, Winter Garden, FL 34787 | 2019-09-26 |
| 1801449996 | Tiffani Green | Behavior Technician | 678 W Bay St Apt 52, Winter Garden, FL 34787 | 2019-07-18 |
| 1811461353 | Ricardo Villalobos Pa | Psychiatry & Neurology | 16606 Broadwater Ave, Winter Garden, FL 34787 | 2019-01-17 |
| 1871078089 | Alton Graydon Cumberbatch Sr. | Pharmacist | 646 S. Dillard Street, Winter Garden, FL 34787 | 2018-10-03 |
| 1629551395 | Andrew Petersen | Physical Therapy Assistant | 5204 W. Colonial Drive, Winter Garden, FL 34787 | 2018-09-10 |
| Find all providers in zip 34787 | ||||
| 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 |
|---|---|---|---|---|
| 1366925646 | Total Renal Care Inc | Clinic/Center | 1210 E Plant St Ste 1202, Winter Garden, FL 34787-2996 | 2018-09-12 |
| 1174902779 | West Orange Winter Garden Dialysis Center LLC | Clinic/Center | 1210 E Plant St Ste 130, Winter Garden, FL 34787-2995 | 2015-05-28 |
| 1972751394 | South Central Florida Dialysis Partners LLC | Clinic/Center | 1222 Winter Garden Vineland Rd, Bldg 3 Ste 100, Winter Garden, FL 34787-4449 | 2008-08-28 |
| 1841283504 | Central Florida Kidney Centers Inc | Clinic/Center | 741 S Dillard St, Winter Garden, FL 34787-3907 | 2005-08-29 |
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| 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 | ||||
| City | WINTER GARDEN |
| Zip Code | 34787 |
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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.