Provider Demographics
NPI:1326025032
Name:METROPOLITAN ANESTHESIA GROUP PL
Entity Type:Organization
Organization Name:METROPOLITAN ANESTHESIA GROUP PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:KATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-460-0517
Mailing Address - Street 1:PO BOX 2474
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34954
Mailing Address - Country:US
Mailing Address - Phone:772-460-0517
Mailing Address - Fax:772-460-0518
Practice Address - Street 1:1331 N LAWNWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950
Practice Address - Country:US
Practice Address - Phone:772-460-0517
Practice Address - Fax:772-460-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-23
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47005174400000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8933Medicare UPIN