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General NPI Number Information
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NPI Number | 1316751647
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Entity Type | Organization
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Legal Business Name | MD CARDIAC ANESTHESIA AND CRITICAL CARE PLLC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 3001 CASTELLI BLVD
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City | MOUNT DORA
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State | FL
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Zip | 32757-6519
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Country | US
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Telephone | 773-987-2903
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 CASTELLI BLVD
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City | MOUNT DORA
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State | FL
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Zip | 32757-6519
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Country | US
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Telephone | 773-987-2903
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Fax |
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Authorized Official
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Title or Position | DIRECTOR CARDIAC ANESTHESIA
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Name | DR. DILLON TINEVEZ
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Credential | MD
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Telephone | 773-987-2903
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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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