Provider Demographics
NPI:1225072069
Name:OSCEOLA ANESTHESIA ASSOCIATES, LLC
Entity Type:Organization
Organization Name:OSCEOLA ANESTHESIA ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:NEGRIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-424-3829
Mailing Address - Street 1:PO BOX 100806
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0806
Mailing Address - Country:US
Mailing Address - Phone:800-901-2102
Mailing Address - Fax:423-892-5838
Practice Address - Street 1:700 WEST OAK STREET
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4996
Practice Address - Country:US
Practice Address - Phone:407-846-2266
Practice Address - Fax:407-518-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
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
FLCK5470OtherRAILROAD MEDICARE
FL265560800Medicaid
FL34397OtherBCBSFL
FL265560800Medicaid