Provider Demographics
NPI:1063471514
Name:ANESTHESIA GROUP OF SARASOTA PA
Entity Type:Organization
Organization Name:ANESTHESIA GROUP OF SARASOTA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:T
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:LEGARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-342-8200
Mailing Address - Street 1:2653 STICKNEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-6019
Mailing Address - Country:US
Mailing Address - Phone:941-342-8200
Mailing Address - Fax:941-342-8201
Practice Address - Street 1:2653 STICKNEY POINT RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6019
Practice Address - Country:US
Practice Address - Phone:941-342-8200
Practice Address - Fax:941-342-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377524100Medicaid
FL33327OtherBLUE CROSS BLUE SHIELD
FL33327OtherBLUE CROSS BLUE SHIELD