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General NPI Number Information
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NPI Number | 1568838589
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL REHABILITATION OF SOUTH FLORIDA, INC.
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 3501 HEALTH CENTER BLVD
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-8127
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Country | US
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Telephone | 239-949-6126
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 452439
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City | SUNRISE
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State | FL
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Zip | 33345-2439
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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 | 954-838-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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