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General NPI Number Information
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NPI Number | 1033729975
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Entity Type | Organization
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Legal Business Name | LAWNWOOD ANESTHESIA PROVIDERS LLC
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 1700 S 23RD ST
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City | FORT PIERCE
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State | FL
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Zip | 34950-4803
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Country | US
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Telephone | 772-461-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 745851
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City | ATLANTA
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State | GA
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Zip | 30374-5851
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KAREN VAUGHN
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Credential |
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Telephone | 919-518-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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