Healthcare Provider Details

I. General information

NPI: 1801801527
Provider Name (Legal Business Name): C R ANESTHESIA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 N SUNCOAST BLVD C/O SEVEN RIVERS REGIONAL
CRYSTAL RIVER FL
34428
US

IV. Provider business mailing address

PO BOX 742318
ATLANTA GA
30374-2103
US

V. Phone/Fax

Practice location:
  • Phone: 317-614-9863
  • Fax: 844-876-0873
Mailing address:
  • Phone: 855-250-6016
  • Fax: 855-206-8399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LEONARD CALODNEY
Title or Position: PRESIDENT
Credential: MD
Phone: 352-795-4008