1053205344 NPI number — NUEVA VIDA DIALYSIS CENTER LLC

Table of content: DR. FATHIMATHUZ ZOHRA YASIN PHARMD (NPI 1831814227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053205344 NPI number — NUEVA VIDA DIALYSIS CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NUEVA VIDA DIALYSIS CENTER LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053205344
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2344 NW 7TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33125-3249
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-786-7547
Provider Business Mailing Address Fax Number:
786-687-5231

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2344 NW 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33125-3249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-786-7547
Provider Business Practice Location Address Fax Number:
786-687-5231
Provider Enumeration Date:
06/03/2025

Additional Information

Authorized Official

Authorized Official Last Name:
FERNANDEZ
Authorized Official First Name:
ROSY
Authorized Official Middle Name:
MARIAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
305-786-7547

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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