Provider Demographics
NPI:1376830430
Name:ANESTHESIA PARTNERS OF THE GULF COAST LLC
Entity Type:Organization
Organization Name:ANESTHESIA PARTNERS OF THE GULF COAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KONDAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-483-5730
Mailing Address - Street 1:1220 E VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-7151
Mailing Address - Country:US
Mailing Address - Phone:941-484-5000
Mailing Address - Fax:941-484-4488
Practice Address - Street 1:1220 E VENICE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-7151
Practice Address - Country:US
Practice Address - Phone:941-484-5000
Practice Address - Fax:941-484-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Single Specialty