MEDICARE: ANESCO CENTRAL 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	:	1710975925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESCO CENTRAL LLC

Provider Business Mailing Address
First Line	:	4631 NW 31ST AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3433
Country	:	US
Telephone Number	:	954-485-5666
Fax Number	:	954-484-1651

Provider Business Practice Location Address
First Line	:	4631 NW 31ST AVE
Second Line	:	#128
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3433
Country	:	US
Telephone Number	:	954-485-5666
Fax Number	:	954-484-1651

Authorized Official
Title or Position	:	CEO
Name	:	RICHARD MELI
Credential	:	M.D.
Telephone Number	:	954-485-5666

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	08/22/2020

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Directions to “ANESCO CENTRAL LLC ” Practice Location

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