Provider Demographics
NPI:1942665807
Name:APOLLO RENAL CENTER MIAMI LLC
Entity Type:Organization
Organization Name:APOLLO RENAL CENTER MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FEDERICO
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:DUMENIGO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:305-545-3090
Mailing Address - Street 1:2601 SW 37TH AVE
Mailing Address - Street 2:SUITE 138
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2700
Mailing Address - Country:US
Mailing Address - Phone:305-448-6261
Mailing Address - Fax:305-448-6268
Practice Address - Street 1:955 NW 3RD ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33128-1274
Practice Address - Country:US
Practice Address - Phone:305-545-3090
Practice Address - Fax:305-545-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-20
Last Update Date:2015-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment