Healthcare Provider Details
I. General information
NPI: 1235468653
Provider Name (Legal Business Name): DELRAY ANESTHESIA SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2009
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4675 LINTON BLVD
DELRAY BEACH FL
33445-6615
US
IV. Provider business mailing address
4675 LINTON BLVD
DELRAY BEACH FL
33445-6615
US
V. Phone/Fax
- Phone: 561-499-9585
- Fax:
- Phone: 561-499-9585
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
ASTROVE
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 908-653-9399