MEDICARE: AMERICAN ANESTHESIOLOGY OF MINNESOTA, P.A.

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	367500000X	Certified Registered Nurse Anesthetist
2	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1588669840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN ANESTHESIOLOGY OF MINNESOTA, P.A.

Provider Business Mailing Address
First Line	:	1500 CONCORD TER
Second Line	:	4TH FLOOR
City	:	SUNRISE
State	:	FL
Zip	:	33323-2815
Country	:	US
Telephone Number	:	800-243-3839
Fax Number	:	844-636-1410

Provider Business Practice Location Address
First Line	:	800 E 28TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-3723
Country	:	US
Telephone Number	:	612-863-4000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CURTIS B. PICKERT
Credential	:	M.D
Telephone Number	:	800-243-3839

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	01/03/2018

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