Healthcare Provider Details

I. General information

NPI: 1750713699
Provider Name (Legal Business Name): SWEET DREAMS NURSE ANESTHESIOLOGY OF SC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 SEVEN FARMS DR STE 210
DANIEL ISLAND SC
29492-8500
US

IV. Provider business mailing address

PO BOX 850001 DEPT #986
ORLANDO FL
32885-0986
US

V. Phone/Fax

Practice location:
  • Phone: 941-360-1566
  • Fax: 941-358-9818
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateSC

VIII. Authorized Official

Name: JARED B. DERANEY
Title or Position: MEMBER MANAGER
Credential: CRNA
Phone: 941-360-1566