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NPI Code Detail

MEDICARE: SHERIDAN RADIOLOGY SERVICES OF VIRGINIA, INC

MEDICARE: SHERIDAN RADIOLOGY SERVICES OF VIRGINIA, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1558605279
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERIDAN RADIOLOGY SERVICES OF VIRGINIA, INC
Provider Business Mailing Address
First Line : PO BOX 452467
Second Line :
City : SUNRISE
State : FL
Zip : 33345-2467
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7918 ARBOR CREST WAY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33412-0000
Country : US
Telephone Number : 630-776-3318
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : GILBERT DROZDOW
Credential : MD
Telephone Number : 954-838-2371
Provider Enumeration Date : 11/19/2012
Last Update Date : 09/19/2019

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