Healthcare Provider Details

I. General information

NPI: 1720909732
Provider Name (Legal Business Name): GREATER FLORIDA ANESTHESIOLOGISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 MEDICAL PARK BLVD STE 405
WELLINGTON FL
33414-3183
US

IV. Provider business mailing address

PO BOX 745723
ATLANTA GA
30374-5723
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5000
  • Fax:
Mailing address:
  • Phone: 954-939-5000
  • Fax: 866-250-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTOPHER KENNEDY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 207-807-9009