MEDICARE: GLOBAL ANESTHESIA SERVICE 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	207LP2900X	Pain Medicine (Anesthesiology) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03817	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	ME80523	OTHER	FL	DR DOVIAK STATE LICENSE

General Provider Information

NPI Number	:	1750586327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL ANESTHESIA SERVICE LLC

Provider Business Mailing Address
First Line	:	PO BOX 91713
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33804-1713
Country	:	US
Telephone Number	:	352-867-8898
Fax Number	:	352-732-6282

Provider Business Practice Location Address
First Line	:	3340 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-1974
Country	:	US
Telephone Number	:	352-867-8898
Fax Number	:	352-732-6282

Authorized Official
Title or Position	:	MD
Name	:	DR. RICHARD DOVIAK
Credential	:	MD
Telephone Number	:	352-867-8898

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	05/28/2010

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Directions to “GLOBAL ANESTHESIA SERVICE LLC ” Practice Location

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