Provider Demographics
NPI:1316205339
Name:GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC
Other - Org Name:GTBA LMC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-844-4396
Mailing Address - Street 1:809 S ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2407
Mailing Address - Country:US
Mailing Address - Phone:813-844-4434
Mailing Address - Fax:813-844-4972
Practice Address - Street 1:201 14TH ST SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3133
Practice Address - Country:US
Practice Address - Phone:813-844-4434
Practice Address - Fax:813-844-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty