NPI Code Detail JSON Logo

1962355081 NPI number — BEDROCK ANESTHESIA LLC

NPI Number: 1962355081
Health Care Provider/Practitioner: BEDROCK ANESTHESIA LLC

Information about “1962355081” NPI (BEDROCK ANESTHESIA LLC) exists in 1962355081 in HTML format HTML  |  1962355081 in plain Text format TXT  |  1962355081 in PDF (Portable Document Format) PDF  |  1962355081 in an XML format XML  formats.

NPI Number : 1962355081 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962355081",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BEDROCK ANESTHESIA LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 166031",
    "SecondLineMailingAddress": "LOCKBOX #166031",
    "MailingAddressCityName": "ALTAMONTE SPRINGS",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32716-6031",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2217 JUANITA DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW SMYRNA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32168-8442",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "407-908-3139",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/18/2026",
    "LastUpdateDate": "02/18/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KNIGHT",
    "AuthorizedOfficialFirstName": "ALEJANDRO",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "AUTHORIZED OFFICIAL",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CRNA",
    "AuthorizedOfficialTelephoneNumber": "407-592-9810",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207L00000X",
        "TaxonomyName": "Anesthesiology Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.