Healthcare Provider Details

I. General information

NPI: 1518874429
Provider Name (Legal Business Name): BLUE HORIZON ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 TAMIAMI TRL S STE 169
VENICE FL
34285-2426
US

IV. Provider business mailing address

842 SUNSET LAKE BLVD STE 301
VENICE FL
34292-7552
US

V. Phone/Fax

Practice location:
  • Phone: 615-517-2162
  • Fax: 941-218-4825
Mailing address:
  • Phone: 615-517-2162
  • Fax: 941-218-4825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY JOB
Title or Position: OWNER/AO
Credential: MD
Phone: 615-517-2162