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General NPI Number Information
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NPI Number | 1518230036
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Entity Type | Organization
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Legal Business Name | DIXIE HIGHWAY INPATIENT SERVICES LLC
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 20900 BISCAYNE BLVD
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City | AVENTURA
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State | FL
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Zip | 33180-1407
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Country | US
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Telephone | 305-682-7000
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Fax | 727-536-2896
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Provider Business Mailing Address
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Address Line | 18167 US HIGHWAY 19 N SUITE 650
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City | CLEARWATER
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State | FL
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Zip | 33764-3528
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KATHLEEN KONDAS
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Credential |
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Telephone | 973-251-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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