Provider Demographics
NPI:1467966812
Name:CARIBBEAN SUN ANESTHESIA LLC
Entity Type:Organization
Organization Name:CARIBBEAN SUN ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:C
Authorized Official - Last Name:LASSALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-878-7272
Mailing Address - Street 1:361 CALLE GALILEO APT 14F
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4549
Mailing Address - Country:US
Mailing Address - Phone:305-494-3811
Mailing Address - Fax:
Practice Address - Street 1:KM 0. CALLE 129
Practice Address - Street 2:HOSPITAL PAVIA ARECIBO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17949207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty