Provider Demographics
NPI:1932988037
Name:MIAMI BEACH ELITE DIALYSIS CLINIC LLC
Entity type:Organization
Organization Name:MIAMI BEACH ELITE DIALYSIS CLINIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-213-0337
Mailing Address - Street 1:714 W 51ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2615
Mailing Address - Country:US
Mailing Address - Phone:954-451-2431
Mailing Address - Fax:888-781-7746
Practice Address - Street 1:714 W 51ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2615
Practice Address - Country:US
Practice Address - Phone:954-451-1431
Practice Address - Fax:888-781-7746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment