Dialysis Center of North Brevard, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

DIALYSIS CENTER OF NORTH BREVARD, LLC

Practice address

830 Century Medical Dr
Suite C
Titusville, FL 32796-2149

Phone

(321) 269-6270

NPI assigned

Jul 9, 2009

Organization subpart

Yes

Parent organization

NORTH BREVARD MEDICAL SUPPORTAs reported in NPPES

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

Authorized official

Name

Dr. Imran Rashid, MD

Title

Medical Director

Phone

(321) 269-6270

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

North Brevard Medical

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1629207873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 CENTURY MEDICAL DR",
            "address_2": "SUITE C",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962149",
            "telephone_number": "321-269-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 CENTURY MEDICAL DR",
            "address_2": "SUITE C",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962149",
            "telephone_number": "321-269-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CENTER OF NORTH BREVARD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH BREVARD MEDICAL SUPPORT",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "RASHID",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "321-269-6270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "06643A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayne Ellen Derocher, APRN
• Mary Devereaux
• Devereux Foundation
• Diabetic Healthlink, LLC
• Dialysis & Kidney Center of North Brevard Inc
• Diamedics, LLC
• Sara Alejandra Diaz, CNA
• Frank Theodore Dienst III, MD
• Stephanie Paige Difrancesco
• Sheila Marie Dilling, CD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Titusville, FL
• Providers in Titusville, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.