MEDICARE: NEW TAMPA ANESTHESIA SERVICES 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	:	1326221037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW TAMPA ANESTHESIA SERVICES LLC

Provider Business Mailing Address
First Line	:	5501 W GRAY ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1007
Country	:	US
Telephone Number	:	813-569-6500
Fax Number	:	813-569-6262

Provider Business Practice Location Address
First Line	:	2407 CYPRESS RIDGE BLVD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-6312
Country	:	US
Telephone Number	:	813-991-7575
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL T DOYLE
Credential	:
Telephone Number	:	813-569-6500

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	12/17/2007

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