Healthcare Provider Details
I. General information
NPI: 1538821947
Provider Name (Legal Business Name): SHERIDAN HEALTHCORP, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/13/2021
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
460 N STATE ROAD 7
ROYAL PALM BEACH FL
33411-3514
US
IV. Provider business mailing address
PO BOX 744538
ATLANTA GA
30374-4538
US
V. Phone/Fax
- Phone: 561-792-7333
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
VAUGHN
Title or Position: OFFICER
Credential:
Phone: 973-251-1132