Provider Demographics
NPI:1093003535
Name:SERENITY ANESTHESIA LLC
Entity Type:Organization
Organization Name:SERENITY ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MITCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-232-4486
Mailing Address - Street 1:PO BOX 6277
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62708-6277
Mailing Address - Country:US
Mailing Address - Phone:888-851-4642
Mailing Address - Fax:240-342-3837
Practice Address - Street 1:2800 BAHIA VISTA ST
Practice Address - Street 2:STE 300
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2710
Practice Address - Country:US
Practice Address - Phone:941-373-9808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty