Organization
SHERIDAN HEALTHCARE OF NORTH TEXAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(877) 328-1119
Entity
Organization
Contact information
Practice address
1613 HARRISON PKWY, #200, SUNRISE, FL 33323-2853
(954) 838-2371
Mailing address
PO BOX 452319, SUNRISE, FL 33345-2319
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0028KK
BC/BS
TX
05
—
159857501
—
TX
Enumeration date
11/29/2005
Last updated
12/17/2020
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