Provider Demographics
NPI:1578589909
Name:ANESTHESIA ASSOCIATES MD PA
Entity Type:Organization
Organization Name:ANESTHESIA ASSOCIATES MD PA
Other - Org Name:ANESTHESIA ASSOCIATES CONNOR MYERS LINGENFELTER NAGEL & SIMON MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-299-1231
Mailing Address - Street 1:567 AVENUE K SE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-4215
Mailing Address - Country:US
Mailing Address - Phone:863-299-1231
Mailing Address - Fax:863-299-1233
Practice Address - Street 1:567 AVENUE K SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4215
Practice Address - Country:US
Practice Address - Phone:863-299-1231
Practice Address - Fax:863-299-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00002Medicare PIN