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NPI Code Detail

MEDICARE: SHERIDAN EMERGENCY PHYSICIAN SERVICES INC

MEDICARE: SHERIDAN EMERGENCY PHYSICIAN SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363L00000XNurse Practitioner
3207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
245846OTHERFLBC/BS

General Provider Information

NPI Number : 1306829858
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERIDAN EMERGENCY PHYSICIAN SERVICES INC
Provider Business Mailing Address
First Line : PO BOX 848508
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33084-0508
Country : US
Telephone Number : 954-838-2371
Fax Number :
Provider Business Practice Location Address
First Line : 160 NW 170TH ST
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33169-5521
Country : US
Telephone Number : 305-654-5234
Fax Number :
Authorized Official
Title or Position : OFFICER
Name : KATHY KONDAS
Credential :
Telephone Number : 954-838-2371
Provider Enumeration Date : 11/29/2005
Last Update Date : 08/16/2019

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Directions to “SHERIDAN EMERGENCY PHYSICIAN SERVICES INC ” Practice Location

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