Provider Demographics
NPI:1609593326
Name:GREATER GAINESVILLE ANESTHESIA ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GREATER GAINESVILLE ANESTHESIA ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-418-4700
Mailing Address - Street 1:3414 PEACHTREE RD NE STE 340
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1137
Mailing Address - Country:US
Mailing Address - Phone:425-803-3885
Mailing Address - Fax:866-665-8561
Practice Address - Street 1:208 SW PROSPERITY PL
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32024-0684
Practice Address - Country:US
Practice Address - Phone:386-487-3930
Practice Address - Fax:866-665-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty