Provider Demographics
NPI:1083905491
Name:DONATE DIALYSIS INSTITUTE INC
Entity Type:Organization
Organization Name:DONATE DIALYSIS INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-856-3287
Mailing Address - Street 1:1871 CORAL WAY
Mailing Address - Street 2:STE 101-B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2786
Mailing Address - Country:US
Mailing Address - Phone:305-856-3287
Mailing Address - Fax:305-856-3288
Practice Address - Street 1:1871 CORAL WAY
Practice Address - Street 2:STE 101-B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2786
Practice Address - Country:US
Practice Address - Phone:305-856-3287
Practice Address - Fax:305-856-3288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment