Provider Demographics
NPI:1063763159
Name:ALL ACCESS MOBILE HEMODIALYSIS,LLC
Entity type:Organization
Organization Name:ALL ACCESS MOBILE HEMODIALYSIS,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:BARRAGAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:800-381-7639
Mailing Address - Street 1:PO BOX 11434
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-1434
Mailing Address - Country:US
Mailing Address - Phone:800-381-7639
Mailing Address - Fax:800-381-7639
Practice Address - Street 1:100 OPAL HILL CIR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-2018
Practice Address - Country:US
Practice Address - Phone:800-381-7639
Practice Address - Fax:800-381-7639
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALL ACCESS MOBILE HEMODIALYSIS,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-28
Last Update Date:2013-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WC1600X, 163WR0400X, 2472R0900X
FLRN1612642163W00000X, 163WA2000X, 163WC1600X, 163WH0200X, 163WH1000X, 163WP0000X, 163WN1003X, 163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Multi-Specialty
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff DevelopmentGroup - Multi-Specialty
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitationGroup - Multi-Specialty
No2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal DialysisGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
No163WP0000XNursing Service ProvidersRegistered NursePain ManagementGroup - Multi-Specialty
No163WN1003XNursing Service ProvidersRegistered NurseNutrition SupportGroup - Multi-Specialty