Provider Demographics
NPI:1518244383
Name:OUTPATIENT ANESTHESIA OF SOUTHWEST FLORIDA INC
Entity Type:Organization
Organization Name:OUTPATIENT ANESTHESIA OF SOUTHWEST FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:TSCHAPPAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-939-4903
Mailing Address - Street 1:12511 WORLD PLAZA LN BLDG 50
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3991
Mailing Address - Country:US
Mailing Address - Phone:239-939-4903
Mailing Address - Fax:239-939-0151
Practice Address - Street 1:12511 WORLD PLAZA LN BLDG 50
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3991
Practice Address - Country:US
Practice Address - Phone:239-939-4903
Practice Address - Fax:239-939-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047526174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID