Organization
INTERVENTIONAL REHABILITATION OF SOUTH FLORIDA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(954) 838-2371
Entity
Organization
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2000
Mailing address
PO BOX 452439, SUNRISE, FL 33345-2439
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256380100
—
FL
01
—
38751
BC/BS
FL
Enumeration date
11/30/2005
Last updated
09/20/2019
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