Healthcare Provider Details

I. General information

NPI: 1861647075
Provider Name (Legal Business Name): NAKANACHI ANESTHESIA PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2008
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5013 N ARMENIA AVE
TAMPA FL
33603-1403
US

IV. Provider business mailing address

5013 N ARMENIA AVE
TAMPA FL
33603-1403
US

V. Phone/Fax

Practice location:
  • Phone: 813-875-0562
  • Fax: 813-871-5236
Mailing address:
  • Phone: 813-875-0562
  • Fax: 813-871-5236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DEVANAND MANGAR
Title or Position: PRESIDENT
Credential: MD
Phone: 813-844-4434