Provider Demographics
NPI:1619928512
Name:FIRST ANESTHESIA ASSOCIATES INC
Entity Type:Organization
Organization Name:FIRST ANESTHESIA ASSOCIATES INC
Other - Org Name:FLORIDA PAIN CENTER OF NAPLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMPOAMOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-659-6400
Mailing Address - Street 1:730 GOODLETTE RD N STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5618
Mailing Address - Country:US
Mailing Address - Phone:239-659-6400
Mailing Address - Fax:239-659-7030
Practice Address - Street 1:730 GOODLETTE RD N
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-659-6400
Practice Address - Fax:239-659-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252554200Medicaid
FL252554200Medicaid