Healthcare Provider Details

I. General information

NPI: 1598604258
Provider Name (Legal Business Name): ANTHONY SEVERE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8846 SKY VISTA CT
ORLANDO FL
32818-8965
US

IV. Provider business mailing address

8846 SKY VISTA CT
ORLANDO FL
32818-8965
US

V. Phone/Fax

Practice location:
  • Phone: 321-279-9313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: