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General NPI Number Information
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NPI Number | 1770202947
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Entity Type | Organization
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Legal Business Name | GA PATRICK ANESTHESIA PA
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 8255 COLLEGE PKWY STE 100
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City | FORT MYERS
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State | FL
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Zip | 33919-5119
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Country | US
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Telephone | 706-271-0100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 943
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City | DALTON
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State | GA
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Zip | 30722-0943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARY PATRICK
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Credential | CRNA
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Telephone | 706-271-0100
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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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Taxonomy #2
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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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