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General NPI Number Information
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NPI Number | 1972913010
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Entity Type | Organization
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Legal Business Name | APNEA ANESTHESIA
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 1496 WACKER AVE SE
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City | PALM BAY
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State | FL
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Zip | 32909-5261
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Country | US
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Telephone | 203-843-0630
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Fax | 321-773-7239
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Provider Business Mailing Address
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Address Line | 1496 WACKER AVE SE
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City | PALM BAY
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State | FL
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Zip | 32909-5261
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Country | US
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Telephone | 203-843-0630
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DWAIN A HAMILTON
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Credential | MD
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Telephone | 203-843-0630
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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 | ME98839
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License Number State | FL
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