Provider Demographics
NPI:1225403520
Name:COMPREHENSIVE ANESTHESIA OF PINELLAS LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE ANESTHESIA OF PINELLAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:MORRISON
Authorized Official - Last Name:FITZ RANDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-263-7457
Mailing Address - Street 1:16618 VILLALENDA DE AVILA
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-5200
Mailing Address - Country:US
Mailing Address - Phone:813-263-7457
Mailing Address - Fax:
Practice Address - Street 1:1988 GULF TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3550
Practice Address - Country:US
Practice Address - Phone:813-263-7457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47220207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty