Healthcare Provider Details

I. General information

NPI: 1689989139
Provider Name (Legal Business Name): GALLOWAY ANESTHESIA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9415 SW 72ND ST SUITE 274
MIAMI FL
33173-5427
US

IV. Provider business mailing address

9500 S DADELAND BLVD 802
MIAMI FL
33156-2824
US

V. Phone/Fax

Practice location:
  • Phone: 305-468-4184
  • Fax: 305-595-1013
Mailing address:
  • Phone: 305-468-4185
  • Fax: 305-675-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES LEAVITT
Title or Position: DIRECTOR
Credential: MD
Phone: 305-595-1013