Provider Demographics
NPI:1508199266
Name:ADVANCED ANESTHESIA OF PALM BEACH COUNTY, PA
Entity Type:Organization
Organization Name:ADVANCED ANESTHESIA OF PALM BEACH COUNTY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RATHFELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-273-2340
Mailing Address - Street 1:5065 STATE ROAD 7
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33449-4615
Mailing Address - Country:US
Mailing Address - Phone:561-273-2340
Mailing Address - Fax:561-273-2331
Practice Address - Street 1:5065 STATE ROAD 7
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33449-4615
Practice Address - Country:US
Practice Address - Phone:561-273-2340
Practice Address - Fax:561-273-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDM844AMedicare PIN