Provider Demographics
NPI:1780823492
Name:ANESTHESIOLOGY PROFESSIONALS LLC
Entity Type:Organization
Organization Name:ANESTHESIOLOGY PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-825-0626
Mailing Address - Street 1:PO BOX 465446
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30042-5446
Mailing Address - Country:US
Mailing Address - Phone:800-242-5080
Mailing Address - Fax:770-237-7346
Practice Address - Street 1:130 TAMIAMI TRL N
Practice Address - Street 2:SUITE 210
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6233
Practice Address - Country:US
Practice Address - Phone:239-434-8707
Practice Address - Fax:770-237-7346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67170207L00000X, 261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF58682Medicare UPIN