Provider Demographics
NPI:1225137383
Name:COMPREHENSIVE ANESTHESIA INC
Entity Type:Organization
Organization Name:COMPREHENSIVE ANESTHESIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:800-778-6623
Mailing Address - Street 1:2 BRIARWOOD CIR
Mailing Address - Street 2:UNIT 113
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1175
Mailing Address - Country:US
Mailing Address - Phone:800-778-6623
Mailing Address - Fax:352-326-4126
Practice Address - Street 1:619 SW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3117
Practice Address - Country:US
Practice Address - Phone:305-326-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1835842367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG0887OtherBLUE SHIELD FL
FL034107000Medicaid
FLQ0303Medicare PIN