Provider Demographics
NPI:1225316672
Name:ELITE ANESTHESIA PRACTITIONERS, LLC
Entity Type:Organization
Organization Name:ELITE ANESTHESIA PRACTITIONERS, LLC
Other - Org Name:ELITE ANESTHESIA PRACTITIONERS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GALANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-867-8898
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0850
Mailing Address - Country:US
Mailing Address - Phone:352-867-8898
Mailing Address - Fax:866-665-2702
Practice Address - Street 1:900 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2442
Practice Address - Country:US
Practice Address - Phone:352-867-8898
Practice Address - Fax:866-665-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty