Provider Demographics
NPI:1881015154
Name:ANESTHESIA UNLIMITED INC
Entity Type:Organization
Organization Name:ANESTHESIA UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:850-785-3185
Mailing Address - Street 1:801 E 6TH STRET
Mailing Address - Street 2:STE 205
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401
Mailing Address - Country:US
Mailing Address - Phone:850-785-3185
Mailing Address - Fax:850-785-6233
Practice Address - Street 1:801 E 6TH STRET
Practice Address - Street 2:STE 205
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401
Practice Address - Country:US
Practice Address - Phone:850-785-3185
Practice Address - Fax:850-785-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9320220367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9320220OtherLICENSE