Healthcare Provider Details

I. General information

NPI: 1356390967
Provider Name (Legal Business Name): ANESTHESIA SOLUTIONS OF PENSACOLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W MORENO ST
PENSACOLA FL
32501-2316
US

IV. Provider business mailing address

PO BOX 10824
BIRMINGHAM AL
35202-0824
US

V. Phone/Fax

Practice location:
  • Phone: 850-437-8390
  • Fax: 850-437-8394
Mailing address:
  • Phone: 205-322-1808
  • Fax: 205-322-1851

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: SCOTT M WELCH
Title or Position: PRESIDENT
Credential:
Phone: 205-322-1808