Healthcare Provider Details

I. General information

NPI: 1538550975
Provider Name (Legal Business Name): BAY AREA CONSORTIUM OF ANESTHESIA SERVICES OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 08/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 45TH ST SUITE 5
WEST PALM BEACH FL
33407-1974
US

IV. Provider business mailing address

1302 WAUGH DR PMB 533
HOUSTON TX
77019-3908
US

V. Phone/Fax

Practice location:
  • Phone: 844-342-2227
  • Fax: 713-401-9758
Mailing address:
  • Phone: 844-342-2227
  • Fax: 713-401-9758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME111629
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME111629
License Number StateFL

VIII. Authorized Official

Name: DR. NELSON K BOND
Title or Position: CEO
Credential: M.D.
Phone: 404-502-1155