Provider Demographics
NPI:1598483638
Name:COMFORT CARE DIALYSIS CENTER, LLC.
Entity Type:Organization
Organization Name:COMFORT CARE DIALYSIS CENTER, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-646-1092
Mailing Address - Street 1:10550 NW 77TH CT STE 405
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2073
Mailing Address - Country:US
Mailing Address - Phone:305-646-1092
Mailing Address - Fax:305-960-7144
Practice Address - Street 1:10550 NW 77TH CT STE 405
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2073
Practice Address - Country:US
Practice Address - Phone:305-646-1092
Practice Address - Fax:305-960-7144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment