Organization
SHERIDAN HEALTHCARE OF LOUISIANA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(954) 838-2371
Entity
Organization
Contact information
Practice address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 981-9100
Mailing address
PO BOX 452015, SUNRISE, FL 33345-2015
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447200
—
LA
01
—
1900G3094Z
BC/BS
LA
Enumeration date
11/29/2005
Last updated
09/18/2019
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