Provider Demographics
NPI:1801263009
Name:NULIFE DIALYSIS, INC.
Entity type:Organization
Organization Name:NULIFE DIALYSIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-414-9291
Mailing Address - Street 1:4805 NW 183 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33055
Mailing Address - Country:US
Mailing Address - Phone:305-952-4925
Mailing Address - Fax:786-657-2801
Practice Address - Street 1:4805 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2955
Practice Address - Country:US
Practice Address - Phone:305-952-4925
Practice Address - Fax:786-657-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment