MEDICARE: NORTHWEST FLORIDA ANESTHESIA CONSULTANTS 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
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CN5114	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1023091535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST FLORIDA ANESTHESIA CONSULTANTS INC

Provider Business Mailing Address
First Line	:	PO BOX 840237
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33084-2237
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 N DAVIS HWY
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-2337
Country	:	US
Telephone Number	:	954-838-2371
Fax Number	:	954-851-1751

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEWIS GOLD
Credential	:	M.D
Telephone Number	:	954-838-2371

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	09/11/2025

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