Organization
PHOENIX OBSTETRICS AND GYNECOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(877) 328-1119
Entity
Organization
Contact information
Practice address
1600 S ANDREWS AVE, SUITE 323, WEST WING, FT LAUDERDALE, FL 33316-2510
(954) 355-5110
(919) 425-0478
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
(919) 425-0478
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME43546
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269096900
—
FL
Enumeration date
05/24/2005
Last updated
07/15/2021
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