MEDICARE: GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1053679076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	265 BROOKVIEW CENTRE WAY
Second Line	:	SUITE 203
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-4052
Country	:	US
Telephone Number	:	813-844-4434
Fax Number	:	813-844-4972

Provider Business Practice Location Address
First Line	:	850 111TH AVE N
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34108-1803
Country	:	US
Telephone Number	:	813-844-4434
Fax Number	:	813-844-4972

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL CORVINI
Credential	:	MD
Telephone Number	:	865-507-7724

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	06/05/2024

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