Provider Demographics
NPI:1891005989
Name:SWEET DREAMS NURSE ANESTHESIOLOGY LLC
Entity Type:Organization
Organization Name:SWEET DREAMS NURSE ANESTHESIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUBERLY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:888-728-0882
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:DEPT 0740
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4080 MCGINNIS FERRY RD STE 102
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3901
Practice Address - Country:US
Practice Address - Phone:888-728-0882
Practice Address - Fax:888-512-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty