Provider Demographics
NPI:1750159695
Name:RENAL NETWORK LLC
Entity type:Organization
Organization Name:RENAL NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHIEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-807-8807
Mailing Address - Street 1:9737 NW 41ST ST STE 1024
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2924
Mailing Address - Country:US
Mailing Address - Phone:305-807-8807
Mailing Address - Fax:954-732-8089
Practice Address - Street 1:9600 SW 8TH ST STE 25
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2968
Practice Address - Country:US
Practice Address - Phone:305-807-8807
Practice Address - Fax:954-732-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No251B00000XAgenciesCase Management