Provider Demographics
NPI:1235899451
Name:DISCO ANESTHESIA LLC
Entity Type:Organization
Organization Name:DISCO ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDISCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-212-1107
Mailing Address - Street 1:2702 WINDSUM WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1138
Mailing Address - Country:US
Mailing Address - Phone:402-212-1107
Mailing Address - Fax:
Practice Address - Street 1:2702 WINDSUM WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1138
Practice Address - Country:US
Practice Address - Phone:402-212-1107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty