Provider Demographics
NPI:1285685586
Name:BOCA RATON AMBULATORY ANESTHESIA SERVICES II
Entity Type:Organization
Organization Name:BOCA RATON AMBULATORY ANESTHESIA SERVICES II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCALETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-426-8840
Mailing Address - Street 1:40 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-3504
Mailing Address - Country:US
Mailing Address - Phone:954-426-8840
Mailing Address - Fax:954-426-6642
Practice Address - Street 1:4800 LINTON BLVD
Practice Address - Street 2:BLDG B
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6584
Practice Address - Country:US
Practice Address - Phone:561-495-9111
Practice Address - Fax:561-495-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical