Organization
AUSTRALIAN PROWFISH SURGICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY KONDAS (OFFICER)
(317) 614-9871
Entity
Organization
Contact information
Practice address
1401 W SEMINOLE BLVD, SANFORD, FL 32771-6743
(469) 401-2386
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0127X
Trauma Surgery Physician
—
—
Other
Enumeration date
12/05/2014
Last updated
04/20/2021
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