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General NPI Number Information
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NPI Number | 1699347971
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Entity Type | Organization
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Legal Business Name | NORTHWOOD ANESTHESIA ASSOCIATES LLC
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 21260 OLEAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6742
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Country | US
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Telephone | 954-939-5000
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Fax | 877-250-6889
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Provider Business Mailing Address
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Address Line | PO BOX 744429
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City | ATLANTA
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State | GA
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Zip | 30374-4429
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Country | US
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Telephone | 954-939-5000
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Fax | 877-250-6889
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CHRISTOPHER KENNEDY
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Credential |
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Telephone | 207-807-9009
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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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