Healthcare Provider Details
I. General information
NPI: 1770045551
Provider Name (Legal Business Name): COMPASSIONATE ANESTHESIA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2019
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7300 BRYAN DAIRY RD STE 495
LARGO FL
33777-1544
US
IV. Provider business mailing address
PO BOX 161903
ALTAMONTE SPRINGS FL
32716-1903
US
V. Phone/Fax
- Phone: 727-451-6780
- Fax: 727-451-6799
- Phone: 941-360-1566
- Fax: 941-358-9818
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SEAN
SINGH
Title or Position: CEO/MANAGER
Credential:
Phone: 941-360-1566