Healthcare Provider Details

I. General information

NPI: 1417385980
Provider Name (Legal Business Name): SHERIDAN RADIOLOGY SERVICES OF PINELLAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2013
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W 68TH ST
HIALEAH FL
33016-1801
US

IV. Provider business mailing address

PO BOX 452136
SUNRISE FL
33345-2136
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-1801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: GILBERT L DROZDOW
Title or Position: PRESIDENT
Credential: MD
Phone: 954-838-2371