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Organization
SOUTHEAST PERINATAL ASSOCIATES, INC.
Active
Organization
SOUTHEAST PERINATAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(877) 328-1119
Entity
Organization
Contact information
Practice address
220 SW 84TH AVE, SUITE 104, PLANTATION, FL 33324-2754
(954) 476-6229
(954) 476-4679
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255648101
—
FL
01
—
38634
BCBS
FL
Enumeration date
11/15/2005
Last updated
07/13/2021
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