Organization
SHERIDAN HEALTHCARE OF MISSOURI INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(954) 939-5950
Entity
Organization
Contact information
Practice address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
(816) 942-4400
Mailing address
PO BOX 744548, ATLANTA, GA 30374-4548
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36101011
BCBS
MO
05
—
507233807
—
MO
01
—
T510000
MEDICARE
MO
Enumeration date
12/14/2005
Last updated
10/26/2021
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