MEDICARE: ALL SAINTS ANESTHESIA & PAIN MANAGEMENT, 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	261Q00000X	Clinic/Center	HCC5566	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1447248414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL SAINTS ANESTHESIA & PAIN MANAGEMENT, P.A.

Provider Business Mailing Address
First Line	:	11377 CORTEZ BLVD
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34613-5409
Country	:	US
Telephone Number	:	352-597-3060
Fax Number	:	352-597-3077

Provider Business Practice Location Address
First Line	:	11377 CORTEZ BLVD
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34613-5409
Country	:	US
Telephone Number	:	352-597-3060
Fax Number	:	352-597-3077

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MICHAEL A. GUARINO
Credential	:
Telephone Number	:	352-597-3060

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	08/22/2020

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