MEDICARE: ALN ANESTHESIA, P.A.

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	ME96802	FL

General Provider Information

NPI Number	:	1386877512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALN ANESTHESIA, P.A.

Provider Business Mailing Address
First Line	:	3439 PINE RIDGE RD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-3884
Country	:	US
Telephone Number	:	239-593-9599
Fax Number	:	239-593-4099

Provider Business Practice Location Address
First Line	:	3439 PINE RIDGE RD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-3884
Country	:	US
Telephone Number	:	239-593-9599
Fax Number	:	239-593-4099

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PRATHIMA MOORTHY
Credential	:	M.D.
Telephone Number	:	239-593-9599

Provider Enumeration Date	:	09/04/2009
Last Update Date	:	09/04/2009

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