Healthcare Provider Details
I. General information
NPI: 1609211432
Provider Name (Legal Business Name): SHERIDAN RADIOLOGY SERVICES OF PINELLAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7918 ARBOR CREST WAY
WEST PALM BEACH FL
33412-0000
US
IV. Provider business mailing address
PO BOX 452136
SUNRISE FL
33345-2136
US
V. Phone/Fax
- Phone: 663-883-0717
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GILBERT
L
DROZDOW
Title or Position: PRESIDENT
Credential: MD
Phone: 954-838-2371