Healthcare Provider Details

I. General information

NPI: 1730141474
Provider Name (Legal Business Name): GUARDIAN ANESTHESIA SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W SWANN AVE
TAMPA FL
33609-4056
US

IV. Provider business mailing address

PO BOX 862506
ORLANDO FL
32886-2506
US

V. Phone/Fax

Practice location:
  • Phone: 813-873-6400
  • Fax: 913-341-5797
Mailing address:
  • Phone: 813-873-6400
  • Fax: 913-341-5797

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: ANTONIO BAYANI
Title or Position: PRESIDENT
Credential: M D
Phone: 813-873-6400