Healthcare Provider Details

I. General information

NPI: 1760780985
Provider Name (Legal Business Name): NPR ANESTHESIA SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 W GRAY ST
TAMPA FL
33609-1007
US

IV. Provider business mailing address

5501 W GRAY ST
TAMPA FL
33609-1007
US

V. Phone/Fax

Practice location:
  • Phone: 813-569-6500
  • Fax: 813-569-6262
Mailing address:
  • Phone: 813-569-6500
  • Fax: 813-569-6262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL DOYLE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 813-569-6500