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NPI Code Detail

MEDICARE: SIGNATURE ANESTHESIA LLC

MEDICARE: SIGNATURE 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
1367500000XCertified Registered Nurse Anesthetist

General Provider Information

NPI Number : 1568658565
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIGNATURE ANESTHESIA LLC
Provider Business Mailing Address
First Line : 6241 ARC WAY
Second Line :
City : FORT MYERS
State : FL
Zip : 33966-1352
Country : US
Telephone Number : 239-278-9955
Fax Number : 239-278-9966
Provider Business Practice Location Address
First Line : 6241 ARC WAY
Second Line :
City : FORT MYERS
State : FL
Zip : 33966-1352
Country : US
Telephone Number : 239-278-9955
Fax Number : 239-278-9966
Authorized Official
Title or Position : OWNER
Name : MS. VICKI DIGBY
Credential : CRNA
Telephone Number : 239-278-9955
Provider Enumeration Date : 09/24/2007
Last Update Date : 09/24/2007

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Directions to “SIGNATURE ANESTHESIA LLC ” Practice Location

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