Provider Demographics
NPI:1063012375
Name:SHERIDAN CHILDRENS HEALTHCARE SERVICES OF COLORADO PC
Entity Type:Organization
Organization Name:SHERIDAN CHILDRENS HEALTHCARE SERVICES OF COLORADO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:DROZDOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-251-1132
Mailing Address - Street 1:7600 W SUNRISE BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4115
Mailing Address - Country:US
Mailing Address - Phone:973-251-1132
Mailing Address - Fax:
Practice Address - Street 1:7700 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2602
Practice Address - Country:US
Practice Address - Phone:303-730-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty