Provider Demographics
NPI:1972858686
Name:BLUE SKY ANESTHESIA LLC
Entity Type:Organization
Organization Name:BLUE SKY ANESTHESIA LLC
Other - Org Name:BLUE SKY ANESTHESIA LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CADMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:352-867-8898
Mailing Address - Street 1:PO BOX 850001 DEPT 912
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0912
Mailing Address - Country:US
Mailing Address - Phone:352-867-8898
Mailing Address - Fax:866-665-2702
Practice Address - Street 1:6015 POINTE WEST BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5542
Practice Address - Country:US
Practice Address - Phone:352-867-8898
Practice Address - Fax:866-665-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty