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General NPI Number Information
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NPI Number | 1992713242
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Entity Type | Organization
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Legal Business Name | GULFSTREAM ANESTHESIA CONSULTANTS PA
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 275 GUTHRIE DR
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City | TROY
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State | PA
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Zip | 16947-8115
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Country | US
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Telephone | 877-204-4155
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Fax | 877-213-5232
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Provider Business Mailing Address
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Address Line | PO BOX 212110
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33421-2110
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Country | US
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Telephone | 877-204-4155
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Fax | 877-213-5232
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAWRENCE M REID
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Credential | MD
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Telephone | 561-204-5230
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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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