Provider Demographics
NPI:1730141474
Name:GUARDIAN ANESTHESIA SERVICES PA
Entity Type:Organization
Organization Name:GUARDIAN ANESTHESIA SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:813-873-6400
Mailing Address - Street 1:PO BOX 862506
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-2506
Mailing Address - Country:US
Mailing Address - Phone:813-873-6400
Mailing Address - Fax:913-341-5797
Practice Address - Street 1:2901 W SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4056
Practice Address - Country:US
Practice Address - Phone:813-873-6400
Practice Address - Fax:913-341-5797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38988OtherBCBS
FLCH3109OtherRAILROAD MEDICARE
FLK1351Medicare ID - Type Unspecified