GRAND DIALYSIS SERVICES LLC (NPI# 1659745149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659745149 |
| Entity Type | Organization |
| Organization Name | GRAND DIALYSIS SERVICES LLC |
| Practice Address |
500 N. Hiatus Road Suite 105 Pembroke Pines FL 33026 |
| Mailing Address |
7765 Johnson St Pembroke Pines FL 33024-6856 |
| Practice Telephone | 9549629640 |
| Mailing Telephone | 9549629640 |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | KEITH CARRASCO (ADMINISTRATOR) |
| Authorized Official Telephone | 9549629640 |
| 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 |
L15000170783 | FL | Ambulatory Health Care Facilities |
| Street Address |
500 N. HIATUS ROAD SUITE 105 |
| City | PEMBROKE PINES |
| State | FL |
| Zip Code | 33026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811488398 | Nathanel A Shammay | Student in an Organized Health Care Education/Training Program | 11251 Renaissance Rd, Cooper City, FL 33026 | 2018-05-21 |
| 1245741313 | Isabel C Gomez | Behavior Technician | 1300 St Charles Place, Pembroke Pines, FL 33026 | 2017-10-17 |
| 1376052233 | Natalie Valentine | Psychologist | 11749 Nw 12th St, Pembroke Pines, FL 33026 | 2017-09-23 |
| 1285159178 | Belkis Perez | Optometrist | 11605 Pines Blvd., Pembroke Pines, FL 33026 | 2017-08-11 |
| 1447792429 | Merlin Abraham | Physical Therapy Assistant | 10794 Pines Blvd #104, Pembroke Pines, FL 33026 | 2016-11-08 |
| 1588024285 | Kerryrose Joyceann Gordon | Registered Nurse | 600 North Hiatus Road, Suite 102, Pembroke Pines, FL 33026 | 2016-02-24 |
| 1992107999 | Therapies 4 Kids, Inc. | Clinic/Center | 1311-1321 N. Palm Avenue, Pembroke Pines, FL 33026 | 2014-09-22 |
| 1073940631 | Lisa Margo Guertin | Nurse Practitioner | 10836 Morningstar Drive, Hollywood, FL 33026 | 2013-09-27 |
| 1881930865 | Carol Elizabeth Farrell | Speech-Language Pathologist | 11704 Melaleuca Way, Cooper City, FL 33026 | 2012-12-20 |
| 1407100993 | Sharon Cam Whitehorn | Physician Assistant | 500 N Hiatus Rd Ste 101, Pembroke Pines, FL 33026 | 2012-11-05 |
| Find all providers in zip 33026 | ||||
| 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 |
|---|---|---|---|---|
| 1962987313 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 8100 Johnson St, Pembroke Pines, FL 33024-6734 | 2018-10-02 |
| 1578975025 | Synergy Dialysis of Pembroke Pines, LLC | Clinic/Center | 20170 Pembroke Pines, Suite 110, Pembroke Pines, FL 33029-1202 | 2014-06-02 |
| 1245653450 | Aquanova Inc | Clinic/Center | 18004 Nw 6th St, 104, Pembroke Pines, FL 33029-2823 | 2014-01-23 |
| 1629335864 | Total Renal Care Inc | Clinic/Center | 10970 Pines Blvd # 70, Pembroke Pines, FL 33026-5208 | 2012-04-12 |
| 1275804031 | Palisades Dialysis LLC | Clinic/Center | 4400 W Hallandale Beach Blvd, Pembroke Pines, FL 33023-4332 | 2012-01-25 |
| 1104019447 | Johnson Dialysis Center LLC | Clinic/Center | 7769 Johnson St, Pembroke Pines, FL 33024-6856 | 2007-08-21 |
| 1871573451 | Pembroke Pines Artificial Kidney Center Inc | Clinic/Center | 12145 Pembroke Rd, Pembroke Pines, FL 33025-1727 | 2006-01-19 |
| 1538648407 | Kidney Doctor's Dialysis Centers | Clinic/Center | 12145 Pembroke Rd, Pembroke Pines, FL 33025-1727 | 2018-08-10 |
| 1700148632 | Professional Dialysis Center, LLC | Clinic/Center | 10021 Pines Blvd, Suite 201, Pembroke Pines, FL 33024-6194 | 2012-06-15 |
| 1780874214 | Renal Carepartners At Memorial West LLC | Clinic/Center | 601 N Flamingo Rd, Suite 109, Pembroke Pines, FL 33028-1015 | 2007-07-31 |
| Find all providers in PEMBROKE PINES | ||||
| City | PEMBROKE PINES |
| Zip Code | 33026 |
Please comment or provide details below to improve the information on GRAND DIALYSIS SERVICES LLC.
| 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.