MEDICARE: ALL AMERICAN ANESTHESIA, 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	:	1538643846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL AMERICAN ANESTHESIA, LLC

Provider Business Mailing Address
First Line	:	PO BOX 80836
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30608-0836
Country	:	US
Telephone Number	:	941-584-6272
Fax Number	:	941-584-6279

Provider Business Practice Location Address
First Line	:	23970 SUNCOAST BLVD
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33980-2739
Country	:	US
Telephone Number	:	941-584-6272
Fax Number	:	941-584-6279

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RONALD WILLIAM DEMASI
Credential	:	MD
Telephone Number	:	941-584-6272

Provider Enumeration Date	:	09/21/2018
Last Update Date	:	05/22/2024

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