Organization · Type 2 NPI

Dva Renal Healthcare Inc

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

NPI number 1104893221 Active

Practice location

4175 W New Haven Ave, Ste 15
Melbourne, FL 32904-1997

Call (321) 956-6252 Map

Fax (321) 956-6464

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...

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NPI record

NPI: 1104893221
Entity type: Organization (Type 2)
Issued: Mar 7, 2006
Last updated: Jun 19, 2025
Status: Active

Other names

<unavail>
Melbourne Dialysis · doing business as
Melbourne Dialysis · doing business as

Authorized official

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

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About NPI 1104893221

Dva Renal Healthcare Inc's National Provider Identifier is 1104893221, issued on Mar 7, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Melbourne, FL. The record was last updated on Jun 19, 2025.