NPIMap

Organization Active NPI

University of South Florida Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tampa, FL
National Provider Identifier
1245324995
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
UNIVERSITY OF SOUTH FLORIDA DIALYSIS CENTER
Practice address
10770 N 46TH Street Suite a 100
Tampa, FL 33617
Phone
(813) 632-7918
Fax
(813) 632-7941
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Izzy Hernandez
Title
Unit Administrator
Phone
(813) 632-7918

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

10770 N 46TH Street Suite a 100
Tampa, FL 33617

Mailing address

10770 N 46TH Street Suite a 100
Tampa, FL 33617
Phone (813) 632-7918

Other identifiers 1

IdentifierTypeStateIssuer
030279101MedicaidFL

National Provider Directory

National Provider Directory

Locations

10770 N 46th St
Ste A100
Tampa, FL 33617
Phone (813) 632-7918

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1245324995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10770 N 46TH STREET SUITE A 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33617",
            "telephone_number": "813-632-7918",
            "fax_number": "813-632-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10770 N 46TH STREET SUITE A 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33617",
            "telephone_number": "813-632-7918",
            "fax_number": "813-632-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH FLORIDA DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "IZZY",
        "authorized_official_title_or_position": "UNIT ADMINISTRATOR",
        "authorized_official_telephone_number": "813-632-7918"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030279101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.