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General NPI Number Information
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NPI Number | 1730856311
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Entity Type | Organization
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Legal Business Name | GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 15238 VIRGINIA STA
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City | ODESSA
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State | FL
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Zip | 33556-3500
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Country | US
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Telephone | 262-902-2116
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Fax |
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Provider Business Mailing Address
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Address Line | 265 BROOKVIEW CENTRE WAY STE 400
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City | KNOXVILLE
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State | TN
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Zip | 37919-4052
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Country | US
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Telephone | 865-985-7062
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT DIRECTOR
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Name | DONALD ADKINS
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Credential |
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Telephone | 865-293-5328
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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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