Organization
LAKE MAGDALENE EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
5234 E FOWLER AVE, TEMPLE TERRACE, FL 33617-2147
(469) 401-2386
Mailing address
13737 NOEL RD, DALLAS, TX 75240-1331
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/15/2017
Last updated
12/22/2020
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