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NPI Code Detail

MEDICARE: SHERIDAN HOSPITALIST SERVICES OF FLORIDA, INC.

MEDICARE: SHERIDAN HOSPITALIST SERVICES OF FLORIDA, 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
1208M00000XHospitalist Physician

General Provider Information

NPI Number : 1548853666
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERIDAN HOSPITALIST SERVICES OF FLORIDA, INC.
Provider Business Mailing Address
First Line : 5565 CENTERVIEW DR STE 107
Second Line :
City : RALEIGH
State : NC
Zip : 27606-3563
Country : US
Telephone Number : 973-251-1132
Fax Number :
Provider Business Practice Location Address
First Line : 3060 MELALEUCA LN
Second Line :
City : PALM SPRINGS
State : FL
Zip : 33461-5174
Country : US
Telephone Number : 561-357-7200
Fax Number :
Authorized Official
Title or Position : VP OF ENROLLMENT
Name : KATHLEEN KONDAS
Credential :
Telephone Number : 973-251-1132
Provider Enumeration Date : 02/19/2021
Last Update Date : 02/19/2021

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