Organization · Type 2 NPI

Dva Healthcare Renal Care Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · South Daytona, FL

NPI number 1013984533 Active

Practice location

955 Foster Way, Ste 306
South Daytona, FL 32119-1731

Call (386) 322-3625 Map

Fax (386) 322-3695

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1013984533
Entity type: Organization (Type 2)
Issued: Mar 2, 2006
Last updated: Feb 21, 2025
Status: Active

Other names

<unavail>
Daytona South Dialysis · doing business as
Daytona South Dialysis · doing business as

Authorized official

Samuel T Wey
VP, Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1013984533

Dva Healthcare Renal Care Inc's National Provider Identifier is 1013984533, issued on Mar 2, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in South Daytona, FL. The record was last updated on Feb 21, 2025.