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General NPI Number Information
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NPI Number | 1578557104
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Entity Type | Organization
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Legal Business Name | NATURE COAST ANESTHESIA PROVIDERS, P.A.
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 17560 US HIGHWAY 441
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City | MOUNT DORA
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State | FL
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Zip | 32757-6711
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Country | US
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Telephone | 386-697-1364
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Fax |
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Provider Business Mailing Address
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Address Line | 421 SE ALFRED MARKHAM ST.
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City | LAKE CITY
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State | FL
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Zip | 32025
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Country | US
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Telephone | 386-697-1364
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Fax | 888-370-3379
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM S JONES
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Credential | CRNA
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Telephone | 386-697-1364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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