Provider Demographics
NPI:1982171633
Name:ARC DIALYSIS PERRINE LLC
Entity Type:Organization
Organization Name:ARC DIALYSIS PERRINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FEDERICO
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:DUMENIGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-322-6412
Mailing Address - Street 1:22165 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170
Mailing Address - Country:US
Mailing Address - Phone:786-504-3003
Mailing Address - Fax:786-601-2498
Practice Address - Street 1:22165 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170
Practice Address - Country:US
Practice Address - Phone:305-448-6261
Practice Address - Fax:305-448-6268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment