Sda Dialysis Center LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

SDA DIALYSIS CENTER LLC

Practice address

3911 Hollywood Blvd Ste 104
Hollywood, FL 33021-6795

Phone

(954) 880-5553

Fax

(954) 208-4533

NPI assigned

Mar 8, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Samer Diab Agha, MD

Title

Ceo

Phone

(917) 803-9091

Specialties & licenses 1

Addresses

Listed as

SDA Dialysis, LLCCCN 682751

Ownership

Profit

Certified

Jul 13, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aza M Abdalla, MD

  • Internal Medicine Physician
  • Pompano Beach, FL
  • NPI 1588903207
  NPD (past)
• Corinne Jenay Steffen, PA-C

  • Medical Physician Assistant
  • Locust, NC
  • NPI 1124536578

  Nephrology

  NPD (past)

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1841885233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7496",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333387496",
            "telephone_number": "917-803-9091",
            "fax_number": "954-208-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 HOLLYWOOD BLVD STE 104",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216795",
            "telephone_number": "954-880-5553",
            "fax_number": "954-208-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDA DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "DIAB AGHA",
        "authorized_official_first_name": "SAMER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-803-9091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott W Hedrick Dcpa
• Christine Scott
• Kamaria Scott
• Marisol Scott
• Phillip Arthur Scott, D.C.
• Jaimol Gigi Sebastian
• Jonathan Seclow, MSOT RL
• Jennifer Allison Sedor, M.D.
• Sedulous, LLC
• Marcia Scott Seeberg, L.M.H.C.

• Nephrology Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.