Healthcare Provider Details

I. General information

NPI: 1710975636
Provider Name (Legal Business Name): SPARTAN ANESTHESIA ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 CATTLEMEN RD SUITE 100
SARASOTA FL
34232
US

IV. Provider business mailing address

PO BOX 978743
DALLAS TX
75397-8743
US

V. Phone/Fax

Practice location:
  • Phone: 855-250-6017
  • Fax: 855-206-8400
Mailing address:
  • Phone: 855-250-6017
  • Fax: 855-206-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ANTHONY DITARANTO
Title or Position: PRESIDENT
Credential: MD
Phone: 941-376-4546