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General NPI Number Information
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NPI Number | 1780131326
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Entity Type | Organization
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Legal Business Name | LYONS ANESTHESIA SERVIES
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 4395 13TH LN NE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-5307
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Country | US
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Telephone | 612-710-5719
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Fax |
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Provider Business Mailing Address
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Address Line | 4395 13TH LN NE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-5307
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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 | CRNA
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Name | KELLY MARIE LYONS
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Credential | CRNA
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Telephone | 612-710-5719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 9309313
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License Number State | FL
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