Provider Demographics
NPI:1013993534
Name:SANTA ROSA ANESTHESIA ASSOCIATES, PA
Entity Type:Organization
Organization Name:SANTA ROSA ANESTHESIA ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-995-0432
Mailing Address - Street 1:PO BOX 30120
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1120
Mailing Address - Country:US
Mailing Address - Phone:850-995-0432
Mailing Address - Fax:850-995-1118
Practice Address - Street 1:6002 BERRYHILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-5062
Practice Address - Country:US
Practice Address - Phone:850-995-0432
Practice Address - Fax:850-995-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45139OtherBLUE CROSS BLUE SHIELD
FLCJ6224OtherMEDICARE RAILROAD
FL45139OtherBLUE CROSS BLUE SHIELD