Healthcare Provider Details

I. General information

NPI: 1780823492
Provider Name (Legal Business Name): ANESTHESIOLOGY PROFESSIONALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 TAMIAMI TRL N SUITE 210
NAPLES FL
34102-6233
US

IV. Provider business mailing address

PO BOX 465446
LAWRENCEVILLE GA
30042-5446
US

V. Phone/Fax

Practice location:
  • Phone: 239-434-8707
  • Fax: 770-237-7346
Mailing address:
  • Phone: 800-242-5080
  • Fax: 770-237-7346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME67170
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberME67170
License Number StateFL

VIII. Authorized Official

Name: JOHN J DOYLE
Title or Position: PRESIDENT
Credential: MD
Phone: 904-825-0626