MEDICARE: BAY AREA CONSORTIUM OF ANESTHESIA SERVICES OF FLORIDA, LLC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME111629	FL
2	208VP0014X	Interventional Pain Medicine Physician	ME111629	FL

General Provider Information

NPI Number	:	1538550975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA CONSORTIUM OF ANESTHESIA SERVICES OF FLORIDA, LLC

Provider Business Mailing Address
First Line	:	1302 WAUGH DR
Second Line	:	PMB 533
City	:	HOUSTON
State	:	TX
Zip	:	77019-3908
Country	:	US
Telephone Number	:	844-342-2227
Fax Number	:	713-401-9758

Provider Business Practice Location Address
First Line	:	3111 45TH ST
Second Line	:	SUITE 5
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-1974
Country	:	US
Telephone Number	:	844-342-2227
Fax Number	:	713-401-9758

Authorized Official
Title or Position	:	CEO
Name	:	DR. NELSON K BOND
Credential	:	M.D.
Telephone Number	:	404-502-1155

Provider Enumeration Date	:	02/06/2015
Last Update Date	:	08/27/2016

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