Healthcare Provider Details
I. General information
NPI: 1528302866
Provider Name (Legal Business Name): SOUTH FLORIDA ANESTHESIA & PAIN TREATMENT, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/26/2012
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 DOUGLAS ROAD
CORAL GABLES FL
33134-6914
US
IV. Provider business mailing address
PO BOX 33058
PALM BEACH GARDENS FL
33420-3058
US
V. Phone/Fax
- Phone: 305-445-8461
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TUSHAR
RAMANI
Title or Position: PRESIDENT
Credential: MD
Phone: 561-623-2000