Healthcare Provider Details

I. General information

NPI: 1114649860
Provider Name (Legal Business Name): SHERIDAN HEALTHCORP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9655 BOYNTON BEACH BLVD
BOYNTON BEACH FL
33472-4421
US

IV. Provider business mailing address

PO BOX 744538
ATLANTA GA
30374-4538
US

V. Phone/Fax

Practice location:
  • Phone: 561-336-7000
  • Fax:
Mailing address:
  • Phone: 973-251-1132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER KENNEDY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 207-807-9009