Organization Active NPI

First Prevention & Dialysis Center,LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Miami Gardens, FL
National Provider Identifier
1710373634
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
FIRST PREVENTION & DIALYSIS CENTER,LLC
Practice address
17940 NW 27TH Ave
Miami Gardens, FL 33056-3505
Phone
(305) 318-3169
Fax
(954) 391-8913
NPI assigned
Apr 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Authorized official

Name
Mrs. Betty Jean Verbal
Title
Ceo
Phone
(305) 318-3169

Specialties & licenses 1

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

Addresses

Primary practice location

17940 NW 27TH Ave
Miami Gardens, FL 33056-3505

Mailing address

8363 Pines Blvd
Pembroke Pines, FL 33024-6607
Phone (305) 318-3169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150626000239 FL Part A Provider - End-Stage Renal Disease Facility (ESRD) 6800107285 Practice locations: Miami Gardens, FL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
First Prevention & Dialysis Center, LLCCCN 682597
Overall star rating
1.0 of 5
Ownership
Profit
Certified
Feb 25, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
14

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2096687First Prevention and Dialysis Center LLC17940 NW 27TH Ave, Miami Gardens, FL 33056Certificate of waiverMay 28, 2027

National Provider Directory

National Provider Directory

Locations

17940 NW 27th Ave
Miami Gardens, FL 33056
Phone (305) 621-8899

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1710373634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8363 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246607",
            "telephone_number": "305-318-3169",
            "fax_number": "954-391-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17940 NW 27TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330563505",
            "telephone_number": "305-318-3169",
            "fax_number": "954-391-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST PREVENTION & DIALYSIS CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "VERBAL",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-318-3169",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.