Healthcare Provider Details

I. General information

NPI: 1811377583
Provider Name (Legal Business Name): ANESTHESIA ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 06/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15680 SW 20TH WAY
MIAMI FL
33185-5824
US

IV. Provider business mailing address

15680 SW 20TH WAY
MIAMI FL
33185-5824
US

V. Phone/Fax

Practice location:
  • Phone: 631-813-7179
  • Fax:
Mailing address:
  • Phone: 631-813-7179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberARNP2906892
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License NumberARNP2906892
License Number StateFL

VIII. Authorized Official

Name: MARTHA MARIA ONER
Title or Position: ARNP/CRNA
Credential: ARNP
Phone: 631-813-7615