UNIVERSAL KIDNEY CENTER OF BOYNTON BEACH INC NPI 1245342658

NPI Information

NPI: 1245342658
Provider Name: UNIVERSAL KIDNEY CENTER OF BOYNTON BEACH INC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 10D0987165

Address:
4895 WINDWARD PASSAGE DRIVE
SUITE #5
BOYNTON BEACH, FL
ZIP 33436
Phone: (561) 740-1981
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UNIVERSAL KIDNEY CENTER OF BOYNTON BEACH INC is an end-stage renal disease (esrd) treatment clinic center in Boynton Beach, FL. UNIVERSAL KIDNEY CENTER OF BOYNTON BEACH INC NPI is 1245342658. The provider is registered as an organization entity type.

The provider's business location address is:

4895 WINDWARD PASSAGE DRIVE
SUITE #5
BOYNTON BEACH, FL
ZIP 33436-741
Phone: (561) 740-1981
Fax: (561) 732-8288

The provider's authorized official is Elmo Angelo V Bartolome .
The authorized official title is Cfo Coo and has the following contact phone number (954) 770-6540.

The CLIA number assigned to this NPI record is 10D0987165 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 10/6/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	CLEA LIC # 800017018	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	890071000	MEDICAID	FLORIDA
2	VE9	OTHER	FLORIDA	BCBS OF FL
3	102782	MEDICARE OSCAR/CERTIFICATION	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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