RENAL LIFE LINK INC (NPI# 1669438495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669438495 |
| Entity Type | Organization |
| Organization Name | RENAL LIFE LINK INC |
| Other Organization Name | DAVENPORT DIALYSIS |
| Practice Address |
45597 Highway 27 Davenport FL 33897-4519 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 8634197408 |
| Practice Fax Number | 8634209165 |
| Mailing Telephone | 6153204593 |
| Mailing Fax Number | 8002935872 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-03-17 |
| Authorized Official Name | JOHN D WINSTEL (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 | 890850800 | 05 |
| Other Name | Type Code |
|---|---|
| DAVENPORT DIALYSIS | Doing Business As Name - Organization |
| Davenport Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144423138 | Renal Life Link Inc | Clinic/Center | 3401 S 19th St, Tacoma, WA 98405-1909 | 2007-06-07 |
| 1295821304 | Renal Life Link Inc | Clinic/Center | 6246 W 95th St, Oak Lawn, IL 60453-2702 | 2006-10-05 |
| 1215023338 | Renal Life Link Inc | Clinic/Center | 8109 South Western Ave, Chicago, IL 60620-5939 | 2006-10-05 |
| 1104921923 | Renal Life Link Inc | Clinic/Center | 7100 Airline Dr, Metairie, LA 70003-5950 | 2006-09-14 |
| 1619079647 | Renal Life Link Inc | Clinic/Center | 2880 W Airline Hwy, La Place, LA 70068-2922 | 2006-09-01 |
| 1932118403 | Renal Life Link Inc | Clinic/Center | 324 S 4th St, Marion, IL 62959-1241 | 2006-08-05 |
| 1609885185 | Renal Life Link Inc | Clinic/Center | 1151 Route 14 W, Benton, IL 62812-1500 | 2006-08-05 |
| 1467461947 | Renal Life Link Inc | Clinic/Center | 1231 State Route 161, Centralia, IL 62801-6739 | 2006-08-05 |
| 1326072638 | Renal Life Link Inc | Clinic/Center | 4102 N. Water Tower Place, Mount Vernon, IL 62864 | 2006-07-10 |
| 1073540506 | Renal Life Link Inc | Clinic/Center | 4019 Johns Rd, Dallas, GA 30132-3420 | 2006-06-28 |
| Street Address |
45597 HIGHWAY 27 |
| City | DAVENPORT |
| State | FL |
| Zip Code | 33897-4519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679182703 | Isis Orozco | Case Management | 9031 Pelican Cove, Davenport, FL 33897 | 2020-07-24 |
| 1669001178 | Jean Maxcene Decarde | Clinic/Center | 548 Solana Circle, Davenport, FL 33897 | 2020-04-06 |
| 1295298818 | Team Reid Solutions, Inc. | Clinic/Center | 843 Kettering Road, Davenport, FL 33897 | 2019-04-10 |
| 1013474063 | Surgeons of Central Florida LLC | General Practice | 755 Jay Bee Avenue, Davenport, FL 33897 | 2019-02-26 |
| 1033687108 | Detsy Z Negron | Registered Nurse | 121 Champions Vue Loop, Apt 101, Davenport, FL 33897 | 2018-11-07 |
| 1487122917 | Angela Burgos | Case Manager/Care Coordinator | 457 La Mirage Street, Davenport, FL 33897 | 2018-11-02 |
| 1790198323 | Compassionate Home Health Care LLC | Non-emergency Medical Transport (VAN) | 248 Plumoso Loop, Davenport, FL 33897 | 2014-06-11 |
| 1740530542 | Santiago Lopez | Chiropractor | 170 Hastead Dr, Davenport, FL 33897 | 2012-09-19 |
| 1942471685 | Carolina Gemma Leuthner | Speech-Language Pathologist | 736 Rodchester Loop, Davenport, FL 33897 | 2008-03-21 |
| 1013926377 | Omayra Torres | Dentist | 7700 Lake Wilson Road, Davenport, FL 33897 | 2006-08-05 |
| Find all providers in zip 33897 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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|---|---|---|---|---|
| 1184014912 | Florida Dialysis Center of Haines City LLC | Clinic/Center | 2340 North Boulevard West, Davenport, FL 33837-8924 | 2015-02-02 |
| 1821499245 | Clyfee Dialysis LLC | Clinic/Center | 1228 E Rusholme St Ste 1000, Davenport, IA 52803-2467 | 2014-09-05 |
| 1881975662 | Green Country Dialysis LLC | Clinic/Center | 5250 Utica Ridge Rd, Davenport, IA 52807-3872 | 2011-09-07 |
| 1700885803 | Quad Cities Kidney Center, Ltd. | Clinic/Center | 120 W Locust St, Davenport, IA 52803-2826 | 2005-07-20 |
| 1093175457 | Fresenius Medical Care Quad Cities, LLC | Clinic/Center | 120 W Locust St, Davenport, IA 52803-2826 | 2016-02-29 |
| 1922048594 | Genesis Health System | Clinic/Center | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2006-06-08 |
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| 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 |
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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.