Healthcare Provider Details

I. General information

NPI: 1811420805
Provider Name (Legal Business Name): SAGE ANESTHESIA SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 66TH ST N
PINELLAS PARK FL
33781-5030
US

IV. Provider business mailing address

PO BOX 865541
ORLANDO FL
32886-5541
US

V. Phone/Fax

Practice location:
  • Phone: 727-828-1460
  • Fax: 727-828-1461
Mailing address:
  • Phone: 888-337-3509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: RAVIINDER PARMAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 239-293-9878