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General NPI Number Information
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NPI Number | 1427432053
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Entity Type | Organization
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Legal Business Name | ELITE ANESTHESIA OF FLORIDA LLC
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 342 CASTAWAY CAY DRIVE
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City | BRADENTON
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State | FL
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Zip | 34209-2209
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Country | US
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Telephone | 201-955-2284
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Fax | 201-955-2267
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Provider Business Mailing Address
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Address Line | 695 ROUTE 46 W
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City | FAIRFIELD
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State | NJ
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Zip | 07004-1592
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Country | US
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Telephone | 201-955-2284
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Fax | 201-955-2267
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILSON NUESA
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Credential | MD
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Telephone | 201-955-2284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | FL
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