Provider Demographics
NPI:1760565972
Name:SOUTH FLORIDA ANESTHESIOLOGISTS, INC
Entity Type:Organization
Organization Name:SOUTH FLORIDA ANESTHESIOLOGISTS, INC
Other - Org Name:SOUTH FLORIDA ANESTHESIOLOGIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:D
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-336-4981
Mailing Address - Street 1:10167 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-7619
Mailing Address - Country:US
Mailing Address - Phone:954-336-4981
Mailing Address - Fax:954-530-4005
Practice Address - Street 1:10167 W SUNRISE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-7619
Practice Address - Country:US
Practice Address - Phone:954-336-4981
Practice Address - Fax:954-530-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty