Provider Demographics
NPI:1619269180
Name:ANESTHESIA INC
Entity Type:Organization
Organization Name:ANESTHESIA INC
Other - Org Name:EMERALD COAST PAIN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-424-3769
Mailing Address - Street 1:3997 COMMONS DR W
Mailing Address - Street 2:SUITE M
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-8443
Mailing Address - Country:US
Mailing Address - Phone:850-424-3769
Mailing Address - Fax:850-460-2491
Practice Address - Street 1:3997 COMMONS DR W
Practice Address - Street 2:SUITE M
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-8443
Practice Address - Country:US
Practice Address - Phone:850-424-3769
Practice Address - Fax:850-460-2491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068957174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty