Healthcare Provider Details

I. General information

NPI: 1447232137
Provider Name (Legal Business Name): ANESTHESIOLOGY ASSOCIATES OF TALLAHASSEE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 CAPITAL MEDICAL BLVD SUITE 200
TALLAHASSEE FL
32308-4674
US

IV. Provider business mailing address

1613 NW 136TH AVE BUILDING C, SUITE #200
SUNRISE FL
33323-2853
US

V. Phone/Fax

Practice location:
  • Phone: 850-385-0144
  • Fax: 850-385-0146
Mailing address:
  • Phone: 954-838-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATHY KONDAS
Title or Position: OFFICER
Credential:
Phone: 954-838-2371