=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871746016
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SWEET DREAMZ ANESTHESIA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2008
-----------------------------------------------------
Last Update Date | 09/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21369 SNOOK CIR
-----------------------------------------------------
City | LAND O LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34639-4904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-468-3726
-----------------------------------------------------
Fax | 888-972-3813
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21369 SNOOK CIR
-----------------------------------------------------
City | LAND O LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34639-4904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-468-3726
-----------------------------------------------------
Fax | 888-972-3813
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. KELVIN GORRELL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 813-468-3726
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | ME78192
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------