Provider Demographics
NPI:1710975636
Name:SPARTAN ANESTHESIA ASSOCIATES PA
Entity Type:Organization
Organization Name:SPARTAN ANESTHESIA ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DITARANTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-376-4546
Mailing Address - Street 1:PO BOX 978743
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75397-8743
Mailing Address - Country:US
Mailing Address - Phone:855-250-6017
Mailing Address - Fax:855-206-8400
Practice Address - Street 1:3333 CATTLEMEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232
Practice Address - Country:US
Practice Address - Phone:855-250-6017
Practice Address - Fax:855-206-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K2182OtherMEDICARE GROUP NUMBER