Healthcare Provider Details

I. General information

NPI: 1790225324
Provider Name (Legal Business Name): SHERIDAN RADIOLOGY SERVICES OF ARIZONA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E VAN BUREN ST
PHOENIX AZ
85006-3742
US

IV. Provider business mailing address

7700 W SUNRISE BLVD 2ND FLOOR MAILSTOP - PL-14
PLANTATION FL
33322-4113
US

V. Phone/Fax

Practice location:
  • Phone: 800-437-2672
  • Fax: 954-851-1746
Mailing address:
  • Phone: 800-437-2672
  • Fax: 954-851-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GILBERT L DROZDOW
Title or Position: PRESIDENT
Credential:
Phone: 800-437-2672