Kidneyspa Hialeah LLC

Primary specialty

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

Legal business name

KIDNEYSPA HIALEAH LLC

Practice address

4286 Palm Ave
Hialeah, FL 33012-4454

Phone

(305) 329-2900

Fax

(305) 428-5698

NPI assigned

Sep 21, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Juan M Cuellar, MD

Title

Ceo

Phone

(305) 329-2900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

KidneySpa Hialeah LLCCCN 682761

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Jul 5, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

16

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Alejandro Pla MD PA

  • Nephrology Physician
  • Hialeah, FL
  • NPI 1245550102

  Member Of

  NPD member

Locations

Networks

• HealthSun Health Plans Network

Affiliated clinicians 1

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

• Juan M Cuellar, MD

  • Nephrology Physician
  • Miami, FL
  • NPI 1285617621

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1801519137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 NW 12TH AVE APT 508",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331282206",
            "telephone_number": "305-329-2900",
            "fax_number": "305-329-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4286 PALM AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124454",
            "telephone_number": "305-329-2900",
            "fax_number": "305-428-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEYSPA HIALEAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "CUELLAR",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-329-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Antonio Khawam Franjie
• Raid Guillermo Kheireddine Ghattas, MD
• Donna Khoshbou, DPM
• Kid Care Pediatrics, P a
• Kidney MD Associates LLC
• Kids Behavioral Therapy LLC
• Kids Centered Therapy Inc
• Kids Quality Therapy Inc.
• Kids R Kool, Inc
• Kids Therapy & Love Corp

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hialeah, FL
• Providers in Hialeah, 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 Oct 16, 2023; 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.