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Organization
40TH STREET INPATIENT SERVICES, LLC
Active
Organization
40TH STREET INPATIENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
11750 SW 40TH ST, MIAMI, FL 33175
(305) 223-3000
Mailing address
PO BOX 37997, PHILADELPHIA, PA 19101-0597
(973) 251-1132
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/23/2014
Last updated
12/05/2019
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