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General NPI Number Information
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NPI Number | 1649745035
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Entity Type | Organization
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Legal Business Name | LOVELOCK ANESTHESIA LLC
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 8040 N WICKHAM RD
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City | MELBOURNE
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State | FL
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Zip | 32940-8367
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Country | US
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Telephone | 239-246-0512
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 486
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City | LAKE FOREST
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State | IL
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Zip | 60045-0486
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Country | US
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Telephone | 800-444-6110
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. WILFRED ROBIN LOVELOCK
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Credential | CRNA
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Telephone | 239-246-0512
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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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