Provider Demographics
NPI:1689953028
Name:VENICE ANESTHESIA SERVICES LLC
Entity Type:Organization
Organization Name:VENICE ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-569-6500
Mailing Address - Street 1:5501 W GRAY ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1007
Mailing Address - Country:US
Mailing Address - Phone:813-569-6500
Mailing Address - Fax:813-864-4030
Practice Address - Street 1:8421 POINTE LOOP DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-2232
Practice Address - Country:US
Practice Address - Phone:941-412-2100
Practice Address - Fax:941-412-2160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SURGERY CENTER HOLDINGS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-16
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty