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General NPI Number Information
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NPI Number | 1275534059
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Entity Type | Organization
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Legal Business Name | GULF COAST ANESTHESIA LLC
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 767 AIRPORT RD
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City | PANAMA CITY
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State | FL
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Zip | 32405-4000
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Country | US
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Telephone | 850-747-0400
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Fax | 850-913-9744
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Provider Business Mailing Address
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Address Line | 767 AIRPORT RD
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City | PANAMA CITY
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State | FL
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Zip | 32405-4000
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Country | US
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Telephone | 850-747-0400
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Fax | 850-913-9744
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JOAN FRANCIS ELZAWAHRY
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Credential | MD
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Telephone | 850-747-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | L04000049725
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License Number State | FL
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