MEDICARE: APNEA ANESTHESIA

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	ME98839	FL

General Provider Information

NPI Number	:	1972913010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APNEA ANESTHESIA

Provider Business Mailing Address
First Line	:	1496 WACKER AVE SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-5261
Country	:	US
Telephone Number	:	203-843-0630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1496 WACKER AVE SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-5261
Country	:	US
Telephone Number	:	203-843-0630
Fax Number	:	321-773-7239

Authorized Official
Title or Position	:	OWNER
Name	:	DWAIN A HAMILTON
Credential	:	MD
Telephone Number	:	203-843-0630

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	04/29/2014

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Directions to “APNEA ANESTHESIA ” Practice Location

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