Healthcare Provider Details

I. General information

NPI: 1740513530
Provider Name (Legal Business Name): SAND ANESTHESIA GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2009
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3754 HIGHWAY 90 STE 120
PACE FL
32571-1097
US

IV. Provider business mailing address

PO BOX 1096
HUNTSVILLE AL
35807-0096
US

V. Phone/Fax

Practice location:
  • Phone: 877-761-7223
  • Fax: 251-217-9151
Mailing address:
  • Phone: 800-436-1018
  • Fax: 559-354-4235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME69740
License Number StateFL

VIII. Authorized Official

Name: DR. WILLIAM H HASS
Title or Position: OWNER
Credential: M.D.
Phone: 877-761-7223