Healthcare Provider Details

I. General information

NPI: 1346818515
Provider Name (Legal Business Name): ANESTHESIA DYNAMICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W BAY DR
LARGO FL
33770-2207
US

IV. Provider business mailing address

LB #8247 PO BOX 95000
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 888-851-4642
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LAURA G ADKINS
Title or Position: OFFICE MANAGER
Credential:
Phone: 240-469-2181