MEDICARE: FMFL 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	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1871127134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FMFL ANESTHESIA, LLC

Provider Business Mailing Address
First Line	:	3414 PEACHTREE RD NE STE 340
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1137
Country	:	US
Telephone Number	:	425-803-3885
Fax Number	:

Provider Business Practice Location Address
First Line	:	6820 INTERNATIONAL CENTER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7129
Country	:	US
Telephone Number	:	800-208-6014
Fax Number	:	706-850-7733

Authorized Official
Title or Position	:	VP OF RCM
Name	:	JEFF L PERRY
Credential	:
Telephone Number	:	502-418-4700

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	07/23/2025

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