Provider Demographics
NPI:1235435348
Name:CARL R NOBACK ANESTHESIA & PAIN MANAGEMENT, INC
Entity Type:Organization
Organization Name:CARL R NOBACK ANESTHESIA & PAIN MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:R
Authorized Official - Last Name:NOBACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-400-9900
Mailing Address - Street 1:5700 MIDNIGHT PASS RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242-3083
Mailing Address - Country:US
Mailing Address - Phone:561-400-9900
Mailing Address - Fax:561-208-8386
Practice Address - Street 1:5700 MIDNIGHT PASS RD
Practice Address - Street 2:SUITE 4
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34242-3083
Practice Address - Country:US
Practice Address - Phone:561-400-9900
Practice Address - Fax:561-208-8386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82169207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty