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NPI Code Detail

MEDICARE: GREATER FLORIDA ANESTHESIOLOGISTS, LLC

MEDICARE: GREATER FLORIDA ANESTHESIOLOGISTS, 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
1367500000XCertified Registered Nurse Anesthetist
2207L00000XAnesthesiology Physician

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 : 1225600406
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER FLORIDA ANESTHESIOLOGISTS, LLC
Provider Business Mailing Address
First Line : PO BOX 745723
Second Line :
City : ATLANTA
State : GA
Zip : 30374-5723
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1401 W BAY DR
Second Line :
City : LARGO
State : FL
Zip : 33770-2207
Country : US
Telephone Number : 877-328-1119
Fax Number :
Authorized Official
Title or Position : OFFICER
Name : KAREN VAUGHN
Credential :
Telephone Number : 877-328-1119
Provider Enumeration Date : 07/15/2021
Last Update Date : 05/19/2023

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