Universal Kidney Center of Davie, Inc.

Primary specialty

Peritoneal Dialysis Registered NurseTaxonomy code 163WD1100X

Legal business name

UNIVERSAL KIDNEY CENTER OF DAVIE, INC.

Practice address

11570 W State Road 84
Davie, FL 33325-4022

Phone

(954) 727-9100

Fax

(954) 727-9880

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Elmo Angelo V. Bartolome

Title

C.F.O/C.O.O

Phone

(954) 770-6540

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982700415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11570 W STATE ROAD 84",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333254022",
            "telephone_number": "954-727-9100",
            "fax_number": "954-727-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11570 W STATE ROAD 84",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333254022",
            "telephone_number": "954-727-9100",
            "fax_number": "954-727-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL KIDNEY CENTER OF DAVIE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARTOLOME",
        "authorized_official_first_name": "ELMO ANGELO",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "C.F.O/C.O.O",
        "authorized_official_telephone_number": "954-770-6540",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163WD1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Dialysis, Peritoneal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Davie, FL
• Providers in Davie, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.