Provider Demographics
NPI:1336110972
Name:SOUTH FLORIDA ANESTHESIA ASSOCIATES PA
Entity Type:Organization
Organization Name:SOUTH FLORIDA ANESTHESIA ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOTTANKARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASKARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-827-2711
Mailing Address - Street 1:7150 W 20TH AVE
Mailing Address - Street 2:SUITE 407
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5529
Mailing Address - Country:US
Mailing Address - Phone:305-827-2711
Mailing Address - Fax:305-827-2113
Practice Address - Street 1:2001 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1801
Practice Address - Country:US
Practice Address - Phone:305-827-2711
Practice Address - Fax:305-827-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00283Medicare ID - Type Unspecified