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General NPI Number Information
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NPI Number | 1508103540
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Entity Type | Organization
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Legal Business Name | AMELIA ANESTHESIA, PL
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Dates
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Enumeration Date | 01/10/2013
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 1250 S 18TH ST ANESTHESIA DEPARTMENT
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-1902
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Country | US
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Telephone | 904-321-3533
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Fax |
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Provider Business Mailing Address
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Address Line | 95429 BARNWELL RD
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-1698
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Country | US
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Telephone | 904-624-7088
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MICHAEL HOWINGTON
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Credential | MD
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Telephone | 904-556-1236
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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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