# PHOENIX OBSTETRICS AND GYNECOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285637066
- **Authorized official:** KATHY KONDAS (OFFICER)
- **Authorized official phone:** (877) 328-1119

## Contact information

- **Practice address:** 1600 S ANDREWS AVE, SUITE 323, WEST WING, FT LAUDERDALE, FL 33316-2510
- **Practice address phone:** (954) 355-5110
- **Practice address fax:** (919) 425-0478
- **Mailing address:** 5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
- **Mailing address fax:** (919) 425-0478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME43546 | FL | Yes |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 07/15/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 269096900 | — | FL |