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General NPI Number Information
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NPI Number | 1285875740
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Entity Type | Organization
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Legal Business Name | BRADENTON ANESTHESIA SERVICES LLC
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Dates
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Enumeration Date | 03/13/2009
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 6002 POINTE WEST BLVD
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City | BRADENTON
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State | FL
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Zip | 34209-5531
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Country | US
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Telephone | 813-569-6500
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Fax | 813-569-6262
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Provider Business Mailing Address
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Address Line | 5501 W GRAY ST
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City | TAMPA
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State | FL
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Zip | 33609-1007
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Country | US
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Telephone | 813-569-6500
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Fax | 813-569-6262
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Authorized Official
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Title or Position | PAYOR RELATIONS DIRECTOR
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Name | NANCY CASTELLANA
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Credential | CPCS
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Telephone | 813-569-6500
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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 |
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License Number State |
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