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General NPI Number Information
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NPI Number | 1326272907
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Entity Type | Organization
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Legal Business Name | SHERIDAN
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 14209 SW 54TH ST
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City | MIAMI
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State | FL
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Zip | 33175-5810
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Country | US
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Telephone | 305-519-6553
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Fax |
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Provider Business Mailing Address
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Address Line | 14209 SW 54TH ST
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City | MIAMI
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State | FL
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Zip | 33175-5810
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Country | US
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Telephone | 305-519-6553
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Fax |
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Authorized Official
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Title or Position | CRNA
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Name | MS. ELIZABETH LOPEZ
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Credential |
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Telephone | 305-519-6553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | RN9233902
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License Number State | FL
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