Provider Demographics
NPI:1851426258
Name:PREMIER ANESTHESIA OF BOYNTON BEACH DIVISION OF PREMIER ANESTHESIA LLC
Entity Type:Organization
Organization Name:PREMIER ANESTHESIA OF BOYNTON BEACH DIVISION OF PREMIER ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-396-6930
Mailing Address - Street 1:6831 HALCYON PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6972
Mailing Address - Country:US
Mailing Address - Phone:334-396-6930
Mailing Address - Fax:334-396-6929
Practice Address - Street 1:2815 S SEACREST BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7934
Practice Address - Country:US
Practice Address - Phone:561-737-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER ANESTHESIA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-23
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty