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General NPI Number Information
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NPI Number | 1033163464
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Entity Type | Organization
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Legal Business Name | LAKE COUNTY ANESTHESIA ASSOCIATES PA
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 600 E DIXIE AVE
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City | LEESBURG
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State | FL
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Zip | 34748-5925
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Country | US
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Telephone | 352-867-8898
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Fax | 352-732-6282
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Provider Business Mailing Address
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Address Line | PO BOX 917756
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City | ORLANDO
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State | FL
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Zip | 32891-7756
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Country | US
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Telephone | 352-867-8898
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Fax | 352-732-6282
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | DR. RICHARD GIOVANELLI
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Credential | MD
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Telephone | 352-867-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | FL
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