Healthcare Provider Details

I. General information

NPI: 1871731471
Provider Name (Legal Business Name): SHERIDAN MEDICAL CENTRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2464 N UNIVERSITY DR
PEMBROKE PINES FL
33024-3624
US

IV. Provider business mailing address

2464 N UNIVERSITY DR
PEMBROKE PINES FL
33024-3624
US

V. Phone/Fax

Practice location:
  • Phone: 954-885-9874
  • Fax:
Mailing address:
  • Phone: 954-885-9874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME0048178
License Number StateFL

VIII. Authorized Official

Name: JOSEPH MANUEL OSSORIO
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 954-885-9874