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NPI Code Detail

MEDICARE: SANTA ROSA ANESTHESIA ASSOCIATES, PA

MEDICARE: SANTA ROSA ANESTHESIA ASSOCIATES, PA
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
1207L00000XAnesthesiology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CJ6224OTHERFLMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
145139OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1013993534
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANTA ROSA ANESTHESIA ASSOCIATES, PA
Provider Business Mailing Address
First Line : PO BOX 30120
Second Line :
City : PENSACOLA
State : FL
Zip : 32503-1120
Country : US
Telephone Number : 850-995-0432
Fax Number : 850-995-1118
Provider Business Practice Location Address
First Line : 6002 BERRYHILL RD
Second Line :
City : MILTON
State : FL
Zip : 32570-5062
Country : US
Telephone Number : 850-995-0432
Fax Number : 850-995-1118
Authorized Official
Title or Position : OWNER
Name : DAVID W. SIMPSON
Credential : MD
Telephone Number : 850-995-0432
Provider Enumeration Date : 12/16/2005
Last Update Date : 08/22/2020

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