Healthcare Provider Details

I. General information

NPI: 1871127134
Provider Name (Legal Business Name): FMFL ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6820 INTERNATIONAL CENTER BLVD
FORT MYERS FL
33912-7129
US

IV. Provider business mailing address

3414 PEACHTREE RD NE STE 340
ATLANTA GA
30326-1137
US

V. Phone/Fax

Practice location:
  • Phone: 800-208-6014
  • Fax: 706-850-7733
Mailing address:
  • Phone: 425-803-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JEFF L PERRY
Title or Position: VP OF RCM
Credential:
Phone: 502-418-4700