Organization
BANGUS SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
2202 STATE AVE STE 108B, PANAMA CITY, FL 32405-4539
(850) 249-1000
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
(973) 251-1132
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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