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NPI Code Detail

MEDICARE: ANESTHESIA OF INDIAN RIVER INC

MEDICARE: ANESTHESIA OF INDIAN RIVER INC
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) PhysicianFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225085442
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANESTHESIA OF INDIAN RIVER INC
Provider Business Mailing Address
First Line : PO BOX 91853
Second Line :
City : ORLANDO
State : FL
Zip : 32891-8953
Country : US
Telephone Number : 352-867-8898
Fax Number : 352-732-6282
Provider Business Practice Location Address
First Line : 1555 INDIAN RIVER BLVD
Second Line : SUITE B-120
City : VERO BEACH
State : FL
Zip : 32960-7103
Country : US
Telephone Number : 352-867-8898
Fax Number : 352-732-6282
Authorized Official
Title or Position : AUTH REP
Name : DONALD PORTELL
Credential : D.O.
Telephone Number : 352-867-8898
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/17/2007

Similar Medicare Providers

1457397242 — DR. ALBERTO PEREZ DIMAGGIO M.D.
Practice Location Address:
1555 INDIAN RIVER BLVD , SUITE B-120
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32960-7103
Practice Phone: 772-778-9621
Practice Fax:
1992731004 — DONALD PORTELL D.O.
Practice Location Address:
1555 INDIAN RIVER BLVD , B-120
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Practice Fax: 772-778-3494
1922028414 — DR. VIRGINIA FEGERT MD
Practice Location Address:
1555 INDIAN RIVER BLVD , B-120
VERO BEACH, FL
32960-7103
Practice Phone: 772-778-9621
Practice Fax:
1659391142 — DR. NIKITAS KLEOPOULOS MD
Practice Location Address:
1555 INDIAN RIVER BLVD , B-120
VERO BEACH, FL
32960-7103
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Practice Fax:
1083637862 — DR. GEOFFREY WOLF MD
Practice Location Address:
1555 INDIAN RIVER BLVD , B-120
VERO BEACH, FL
32960-7103
Practice Phone: 772-778-9621
Practice Fax:
1619990231 — DR. LAURA H WOLF MD
Practice Location Address:
1555 INDIAN RIVER BLVD , B-120
VERO BEACH, FL
32960-7103
Practice Phone: 772-778-9621
Practice Fax:

Directions to “ANESTHESIA OF INDIAN RIVER INC ” Practice Location

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