Organization
SHERIDAN EMERGENCY PHYSICIAN SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(954) 838-2371
Entity
Organization
Contact information
Practice address
160 NW 170TH ST, NORTH MIAMI BEACH, FL 33169-5521
(305) 654-5234
Mailing address
PO BOX 848508, PEMBROKE PINES, FL 33084-0508
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272253400
—
FL
01
—
45846
BC/BS
FL
Enumeration date
11/29/2005
Last updated
08/16/2019
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