Healthcare Provider Details

I. General information

NPI: 1437407681
Provider Name (Legal Business Name): SHERIDAN RADIOLOGY SERVICES OF SOUTH FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2012
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date: 02/10/2023
Reactivation Date: 03/09/2023

III. Provider practice location address

901 45TH ST
WEST PALM BEACH FL
33407-2413
US

IV. Provider business mailing address

PO BOX 3261
INDIANAPOLIS IN
46206-3261
US

V. Phone/Fax

Practice location:
  • Phone: 561-844-6300
  • 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: KAREN VAUGHN
Title or Position: OFFICER
Credential:
Phone: 404-450-4684