Provider Demographics
NPI:1184104069
Name:WEST COAST ANESTHESIA PROVIDERS, LLC
Entity type:Organization
Organization Name:WEST COAST ANESTHESIA PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EFFIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZAKOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-264-8856
Mailing Address - Street 1:4519 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4923
Mailing Address - Country:US
Mailing Address - Phone:727-264-8856
Mailing Address - Fax:727-853-1855
Practice Address - Street 1:4519 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4923
Practice Address - Country:US
Practice Address - Phone:727-264-8856
Practice Address - Fax:727-853-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty