Provider Demographics
NPI:1336480516
Name:SUNSHINE ANESTHESIA INC
Entity Type:Organization
Organization Name:SUNSHINE ANESTHESIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:480-874-7014
Mailing Address - Street 1:PO BOX 7387
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-0013
Mailing Address - Country:US
Mailing Address - Phone:480-874-7014
Mailing Address - Fax:480-874-7015
Practice Address - Street 1:1232 E BROADWAY RD
Practice Address - Street 2:SUITE 205
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1511
Practice Address - Country:US
Practice Address - Phone:480-874-7014
Practice Address - Fax:480-874-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty