Healthcare Provider Details

I. General information

NPI: 1790506434
Provider Name (Legal Business Name): OASIS ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13770 OLD LIVINGSTON RD
NAPLES FL
34109-3856
US

IV. Provider business mailing address

PO BOX 10130
NAPLES FL
34101-0130
US

V. Phone/Fax

Practice location:
  • Phone: 941-468-3092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: CASEY PANEPINTO
Title or Position: AMBR
Credential: CRNA
Phone: 941-468-3092