Provider Demographics
NPI:1821146226
Name:FRESENIUS MEDICAL CARE-EA
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE-EA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOVASCULAR PERFUSIONIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:LORENZO
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:SR
Authorized Official - Credentials:CCP
Authorized Official - Phone:305-823-5000
Mailing Address - Street 1:3540 SW 146TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3741
Mailing Address - Country:US
Mailing Address - Phone:954-430-9116
Mailing Address - Fax:954-430-9116
Practice Address - Street 1:2001 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1801
Practice Address - Country:US
Practice Address - Phone:305-823-5000
Practice Address - Fax:786-639-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty