Australian Lungfish Surgical Specialists LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

AUSTRALIAN LUNGFISH SURGICAL SPECIALISTS LLC

Practice address

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Phone

(469) 401-2386

NPI assigned

Dec 2, 2014

Last updated

Apr 20, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathy Kondas

Title

Officer

Phone

(317) 614-9871

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1285031583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 CENTERVIEW DR STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTRALIAN LUNGFISH SURGICAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "317-614-9871"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boonlak Asher
• Neil George Grant Asthana, M.D.
• Sandra Atkinson, LMT
• Tahne Atkinson
• Fred E Aubert Jr., M.D.
• Australian Lungfish Surgical Specialists LLC
• Margaret Ann Avery, FNP-BC
• Axis Physiotherapy Institute
• Axis Physiotherapy Institute, LLC
• Michelle Gomez Bagsic

• Surgery Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.