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NPI Code Detail

MEDICARE: SUMMERLIN ANESTHESIA, INC.

MEDICARE: SUMMERLIN ANESTHESIA, 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
1367500000XCertified Registered Nurse Anesthetist

General Provider Information

NPI Number : 1245667542
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMERLIN ANESTHESIA, INC.
Provider Business Mailing Address
First Line : 6094 14TH ST W
Second Line : STE 107
City : BRADENTON
State : FL
Zip : 34207-4104
Country : US
Telephone Number : 941-360-1566
Fax Number : 941-358-9818
Provider Business Practice Location Address
First Line : 4035 EVANS AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9308
Country : US
Telephone Number : 239-466-8838
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DAVID MICHAEL GUTSTEIN
Credential : M.D.
Telephone Number : 239-466-8838
Provider Enumeration Date : 10/01/2013
Last Update Date : 05/23/2014

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Directions to “SUMMERLIN ANESTHESIA, INC. ” Practice Location

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