Provider Demographics
NPI:1811377583
Name:ANESTHESIA ENTERPRISE LLC
Entity Type:Organization
Organization Name:ANESTHESIA ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/CRNA
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ONER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:631-813-7615
Mailing Address - Street 1:15680 SW 20TH WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5824
Mailing Address - Country:US
Mailing Address - Phone:631-813-7179
Mailing Address - Fax:
Practice Address - Street 1:15680 SW 20TH WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5824
Practice Address - Country:US
Practice Address - Phone:631-813-7179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2906892282N00000X, 286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1295714228OtherNPI
FL8551OtherMEDICARE