Organization · NPI-2

40th Street Inpatient Services, LLC

Internal Medicine · Miami, FL

NPI number1861815177

StatusActive

Last updated in NPPESDec 5, 2019

Details

NPI: 1861815177
Entity type: Organization (NPI-2)
Legal business name: 40th Street Inpatient Services, LLC
Organization subpart: No
Enumeration date: Jan 23, 2014
Last updated: Dec 5, 2019

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
363L00000X	Nurse Practitioner	–	–
363A00000X	Physician Assistant	–	–

Practice location

11750 Sw 40th St
Miami, FL 33175

Phone 305-223-3000

Mailing address

Po Box 37997
Philadelphia, PA 19101-0597

Phone 973-251-1132

Authorized official

Kathy Kondas
Officer
9732511132

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