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General NPI Number Information
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NPI Number | 1144668617
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Entity Type | Organization
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Legal Business Name | MOBILE ANESTHESIA ASSOCIATES, INC
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 605 UNITED ST REAR
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City | KEY WEST
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State | FL
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Zip | 33040-3229
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Country | US
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Telephone | 863-224-0061
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Fax |
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Provider Business Mailing Address
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Address Line | 605 UNITED ST REAR
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City | KEY WEST
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State | FL
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Zip | 33040-3229
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Country | US
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Telephone | 863-224-0061
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICK JOSEPH RUDDY JR.
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Credential | MD
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Telephone | 863-224-0061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME67160
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License Number State | FL
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