Provider Demographics
NPI:1073504346
Name:MSC ANESTHESIA INC
Entity Type:Organization
Organization Name:MSC ANESTHESIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-794-2020
Mailing Address - Street 1:601 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8610
Mailing Address - Country:US
Mailing Address - Phone:941-745-2727
Mailing Address - Fax:941-745-2112
Practice Address - Street 1:601 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8610
Practice Address - Country:US
Practice Address - Phone:941-745-2727
Practice Address - Fax:941-745-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4600207L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74974OtherBC/BS
61009100OtherUS DEPARTMENT OF LABOR
7462656OtherAETNA
DC7796OtherRAILROAD MEDICARE
7462656OtherAETNA