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NPI Code Detail

MEDICARE: GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC

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
1207LP2900XPain Medicine (Anesthesiology) Physician
2207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1154658318
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 STE 203
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-4052
Country : US
Telephone Number : 813-844-4396
Fax Number : 813-844-4972
Provider Business Practice Location Address
First Line : 5013 N ARMENIA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33603-1403
Country : US
Telephone Number : 813-844-4434
Fax Number : 813-844-4972
Authorized Official
Title or Position : CEO/PRESIDENT
Name : MICHAEL CORVINI
Credential : MD
Telephone Number : 865-507-7724
Provider Enumeration Date : 11/09/2009
Last Update Date : 06/04/2024

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