MEDICARE: ANESTHESIA DU'JOUR, 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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1902675291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIA DU'JOUR, LLC

Provider Business Mailing Address
First Line	:	13711 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2417
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13711 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2417
Country	:	US
Telephone Number	:	813-374-4619
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANITA V LEE
Credential	:	APRN
Telephone Number	:	813-220-9909

Provider Enumeration Date	:	12/27/2023
Last Update Date	:	12/27/2023

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